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DU-UU U laity ol.GepilynONS r-ellnll r+NNuuauun • Building Department `44 Date Received . •l Phone Contact for Permitting O w n e r ' s Name 5 9 - 0 J 0 ( I ©W Owner Phone Number g13 78 - 1 1 ) Owner's Address 3 (3 �0. Y i - Oe Owner Phone Number 2. hG.h1li3 FL- Fee Sitnple Titleholder Name . Owner Phone Number Fee Simple Titleholder Address p ` I r' JOB ADDRESS 3141 CR 139 E - Z hy(1 1 `�s FL Jv5gZ LOT # SUBDIVISION : PARCEL ID# • (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED 101101 NEW CONSTR - ADD /ALT I SIGN n n DEMOLISH INSTALL - REPAIR PROPOSED USE n SFR Q COMM I I OTHER I TYPE OF CONSTRUCTION I BLOCK ^ Q FRAME 1 1 STEEL n 1 DESCRIPTION OF WORK o�� S c, + .5 i)c ao t BUILDING SIZE SQ FOOTAGE HEIGHT I (BUILDING $ a7 OO I ) 0 VALUATION OF TOTAL CONSTRUCTION (ELECTRICAL • $ AMP SERVICE 1 PROGRESS ENERGY Ti W.R.E.C. (PLUMBING $ I (MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I GAS n ROOFING n SPECIALTY I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ((YES NO BUILDER COMPANY SIGNATURE REGISTERED I Y/ N . I FEE CURREI. I Y/ N I Address License # ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREA I Y/ N j Address License # PLUMBER • COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRE1. I Y/ N I Address License # I MECHANICAL COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURREI I Y/ N I Address Ucense # I �� OTHER COMPANY SI 1 I�IID(� Moto i SIGNATURE REGISTERED I Y/ � ° t i FEE CURREI, I Y/ N 1 Address 3 3(Q 1 S Lc.t^S A ` /15 d35 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Farms; 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 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, Stonnwater 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 57500) Agent (for the contractor) or Power of Attomey (for the owner) would be someone wi _ OVER THE COUNTER PERMITTING (Front of Application Only) +< c "' +v rt , , n Reroofs If shingles Sewers Service Upgrades A/C Fences (PIOVB , i,r; , , �.• 4 L ti ,�.. . _ ".^`"" : '• ; Driveways -Not over Counter if on public roadways..needs ROW 4 : as vithi 114 .};(1, ' ' - w. rt,pili Go