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813- 78U -UUZU kill)/ rv111n1.nNNn%..auv,i i n (�j / 6 (f Building Department ( 0 v ` Date Received Phone Contact for Permittln• 8 / Lied, - O 3 ,3 Owners Name 4&V N,l' /7 OfrA?'S Owner Phone Number ( 9 q - /I 0 0 /.7'i e 337& v Owner's Address �� .��/�GJAJ'G/ �./�y/C C '��i ✓t4'�1L�. • Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address / d ,�- JOB ADDRESS 377/ Q A'4 LyN � Ef ilyi hit J/ i L 3350 LOT # SUBDIVISION 6/4.11'ND M 4 , 1 4 , PARCEL ID# 0 3%240 -2x1- 023 0 - 00000— (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED 1►�� NEW CONSTR J ADD /ALT ( 1 SIGN I 1 MOVE I DEMOLISH I INSTALL I REPAIR PROPOSED USE [ 1 SFR 1 1 COMM [ 1 OTHER I TYPE OF CONSTRUCTION . 15K BLOCK [ [ FRAME 1 [ STEEL I 1 OTHER DESCRIPTION OF WORK A Ew CONSTW.UGT OA) "rOw 140,40• BUILDING SIZE SQ FOOTAGE /53 / HEIGHT a 1Z7 9 [ [ BUILDING $ 3 / 6 5 - 0 VALUATION OF TOTAL CONSTRUCTION I 1 ELECTRICAL $ 7 0 AMP SERVICE tigi PROGRESS ENERGY u W.R.E.C. (i PLUMBING $3.7 [ 1 MECHANICAL $ 41.2 95- VALUATION OF MECHANICAL INSTALLATION ( 1 GAS Ti ROOFING 1 1 SPECIALTY I 1 OTHER FINISHED FLOOR ELEVATIONS /2 n FLOOD ZONE AREA [YES ( 1NO i BUILDER COMPANY LEN//Al— /7 SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT 1 Y/ N 1 Addres A_ -• Al 84 fro - 115 'etas /- 33409 License# CI3G /. 551x/ ELECTRICIAN v COMPANY /ONo,u 30 !!J EG cc . .ZA/ C SIGNATURE j REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y / N Address , /Q3 .Y/// 12040 / i.QM/t/'e. 336/3 License # f c 00 0.2.5 PLUMBER COMPANY Ri vJ PL td A4 /A/ 6" SIGNATURE REGISTERED - 1 Y / N FEE CURRENT Y / N Address 4,3v -1 /Jiv 3 ./2I vc2v/£/ 3354 License # CF CQ,2 /So 0 MECHANICAL COMPANY 84 OA/FT'KvMG /�/G� E /9T /•t/a -, .5 SIGNATURE ) REGISTERED 1 Y / N I FEE CURRENT I Y / N Address /'.O. BOX S • s) a/szyONFT/O /Nr PI-3514 ?Vi License # CAC ( 0 6 2 OTHER COMPANY C' , S altieZ/ ROOl •ZVd• SIGNATURE ✓ REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N I Address /2// 51r04L L/i p &-vo SP/4//t/ G /1/4L� F63 r License # CZ CO s7 99 I RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Slit Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence Installed, Sanitary Facilities & 1 dumpster, Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. ****PROPERTY SURVEY required for all NEW construction, Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is required. (A/C upgrades over $5000) '• Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter If on public roadways..needs ROW