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813 -780 -0020 City of Lepnyrnllls rut lint frAppliucului i <br /> Building Department Z //1 V <br /> Date Received T1 /D o2 f - / c Phone Contact for Permitting 4F ` v 70 -- c /Jt <br /> IIIIIIIIIII,ItI , t <br /> Owner's Name /94.11le 10Crnle Owner Phone Number <br /> Owner's Address JIB pial( dr. Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address p�,� <br /> JOB ADDRESS 31c 3 P'i- t i. Dr' Z��L4 Jr/ £T+ / 5- LOT # 6 2 0 <br /> SUBDIVISION //l SjtJl _ Q PARCEL ID# o .z/— dada - 'died- ®d <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED pR NEW CONSTR ADD /ALT I I SIGN I I MOVE I I DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 1 I SFR 1 I COMM I I OTHER I I <br /> TYPE OF CONSTRUCTION 1 I BLOCK I I FRAM ` E ,J.,-,'-� 1 1 STEEL I I OTHER I I <br /> DESCRIPTION OF WORK C4,t, #' tl Led 7 Co•caAut <br /> BUILDING SIZE L9 x39 SQ FOOTAGE Nit t HEIGHT <br /> BUILDING $ 9/ 247 00 VALUATION OF TOTAL CONSTRUCTION <br /> I I ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY 1 1 W.R.E.C. <br /> 7 .€,—.1 kez - <br /> I I PLUMBING $ <br /> I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> GAS 1 1 ROOFING 1 1 SPECIALTY I I OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES I INO <br /> BUILDER 4' �-C 14A40. k' . COMPANY f J 4 C die.h *► .. SIGNATURE /,- _ �� / IS REGISTERED I Y / N 1 FEE CURRENT 1 Y /N I <br /> Address (e sl y Fe k nt 6(J k 2' 4 l7 License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED l Y/ N I FEE CURRENT 1 Y/ N I <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 <br /> Address License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED 1 Y / N I FEE CURRENT I Y/ N I <br /> Address License # <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects <br /> 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. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> * ** *PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) <br /> ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />