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09/22/2010 11:27 7278467195 PAGE 02/03 <br /> elu- rewutrau t4ty oi.t.epuynnn rto(uut /.4ppuwuvr1 <br /> �7 <br /> -Building Deportment -- — <br /> • • Da1a'Rscelved 9.-- cl p2" /0 Phorre'COelaet far?etm . w t & 7 'C t M. <br /> Owner's Name j # / C / eel e y / / / 1 _ Phone Number .• P "7 �f 0•5'.3 <br /> Owner's Address 1 ‘y ' J °"' 5// l/ 1'{^ 004 04 I Owner Phone Number 1 • <br /> Fee s(mple•TIIleholdor Name , 1 _ • 1 Owner Phone Number 1 • <br /> Too Simple TlWeholderAdddr 7 / ( ess 1 / — - -- • <br /> Jon ADDRESS 1 'D 4 0 ) — VP .11-- t J P4J /r• I/ h r . . I .LOT* I / 0 <br /> SUBDIVISION I5,/vl - /1 -f'k(_ /r7.- , PARCEL 10211 0 2-( ). - /`4 12-v-0OpfJ/1 /(',6 <br /> (oBTMNen Moe PRDPErtY TAX H MMCO) <br /> • <br /> WORK PROPOSED ' e Now coNSrn Er r---1 ADD/ALT r slow . Q Q DEMOUSH • <br /> • INSTALL J� REPAIR <br /> PROPOSED USE Q SFR • 0 COMM = * OTHER I . <br /> 'TYPE OF coronRUCTION Q BLOCK Q FR L j , STEEL. Q <br /> DESCRIPTION OF WORK , 1 _514/ / h , / ®d / •_ /iT C <br /> IN <br /> BUILDG SIZE 1. ' • 1 8Q FOOTAGE' __• 1 1 I <br /> BUILDING r „. <br /> ..<. FJ TIONOF L00 kI <br /> ELECTRICAL • r • 1 AMP SERVICE • • Q PROGRESS ENERGY 0 W.R.E.C. <br /> PLUMBING 1; 1 • <br /> 1 MECHANIC/tl IS 1 VALUATION OF MECHANICAL INSTALLATION . <br /> []GAS • I=1 ROOFING 1 <br /> SPECIALTY Q OTHER . <br /> FINISHED FLOOR ELEVATIONS • 1 1 FLOOD ZONE AREA fJYES NO <br /> • <br /> • <br /> 9 ON �ep / _ - - '- - NY ' XI O /J / <br /> J 9 A uBE • i t A /�A d ® d FEE mwraren WI= ,L ' /6C. <br /> Address f . If" /ice : 1. 'j({( Loomed 1 E.e- 1 3oo Sao i I ' <br /> �..r.... --a+.— - - <br /> PLUMBER , 1 - ,�4, �e o�,� P o / SIGNATURE rtmmert o L Y/ N I FEE e m s. J Y/ N ) <br /> Address I 1 . Ueense I —o r f j 1 <br /> MECHANICAL . COMPANY <br /> ( <br /> SIGNATURE mom= gEg J Y / N J FEE cumin en ) Y /.N J • <br /> Address 1 • 1 LloenseS I • <br /> • <br /> ollIER COMPANY 1 ' <br /> SIGNATURE • IE61."TEREn J r / N 1 pee CLE . ( Y / N I <br /> Address I • ' I License # . I <br /> RESIDENTIAL Attach (2) Plot Pean=•(2) Rata or Bulling Planet (1) eat or Energy Fun R.O•W Peenet for new conehuopon. <br /> minimum tan (10) working days after albmlttsl date. Rambled panto, Coneltoollon Plana. Stormwrler Pans w/ SV( Penes N19bted, <br /> • Sanatory Pedalled & 1 dudlloder; St(e Went Permit for subdivlelonsA n pve eele <br /> coMMERCIAI. Attach (2) complete see of Building Plana plus a LBO Safely Page; (1) set of stingy Forme. R O-W Permit for now wnmucUon. • <br /> Mlnhnum ten (10) working deye otter subrnItlel dole. Required meta Corebuction Pko+s, Ston ev ter Plane w/ 811L Pence Ieselled. <br /> • Sanitary FedIeee a 1 dunpater. SIM Work Pane ter en new protects. Al eonenen:lsl regtdremenb must meek dxmpaone <br /> SIGN PERMIT Atbhch (2) Deb of Engineered Plorte. <br /> • ""PROPERTY SURVEY mowed tor NI NEW ctmeduction. . • <br /> dlns:do ee . . <br /> RN out application contpk lily. <br /> Owner a Contractor edges beck or applI aIen, newt end • <br /> • I wow $2.9a0, a Willem of Caw.neentent m. requ sd. .(A/C.up daa. <br /> praevarS7Bed)':" ^•..• <br /> ,.. . . <br /> 'tent (tor the contractor) or Power ter Attorney (tor the owner) wattle* t+om Weerrid <br /> eonet abl(b tnem owner eutrontino sane <br /> OVERTNE'OOUNTER PERMfTTING (Pratt of APPEeapen Only)' <br /> ne roots X 9hMpkas Beware Service tlpaeadae Are r • Pane (PIeVBe nnwrnoun o) • • Driveways-Not over Counter II on public tsadwaye..needeROw . <br /> • <br /> • <br />