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813- 78U -UUZU city of Lepnyrnuis rermlt Application rax- o is- itU -UULI Budding Department Date Received /4 - / 7– A) Phone Contact for Permittin! – Owner's Name /1/1-717 Owner Phone Number Owner's Address I 7/� / / /`7/)I • t')C/" 9( -'D Owner Phone Number Fee Simple Titleholder Name . I _ - Owner Phone Number I Fee Simple Titleholder Address I f------- JOB ADDRESS I e LOT # I SUBDIVISION 1 , PARCEL ID #I (OBTAINED FROM PROPERTY TAX NOTICE) . - WORK PROPOSED I NEW CONSTR _ ADD /ALT SIGN 1 DEMOLISH INSTALL REPAIR PROPOSED USE n SFR I COMM 1 1 OTHER 1 TYPE OF CONSTRUCTION I BLOCK n FRAME 1 I STEEL n 1 DESCRIPTION OF WORK /,W /9e 4P- 7" r If/6'4277e ` /i6-7df,4LL 7 J% y//�e 7 / �1 ,d /ze: 9/w6 fe,r,2c, BUILDING SIZE I SQ FOOTAGE' HEIGHT I nBUILDING $ VALUATION OF TOTAL CONSTRUCTION _,ELECTRICAL $ AMP SERVICE 1 PROGRESS ENERGY I W.R.E.C. (PLUMBING $ � � 7/� ( J I (MECHANICAL $ VALUATION OF MECHANICAL INST CATION - / _ - (. 4 n GAS I I ROOFING I-1 SPECIALTY 1 1 OTHER i FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA n YES NO BUILDER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N I Address I 1 License # I I ELECTRICIAN ", COMPANY l/� ase /- SIGNATURE f ��G,7/ �/� REGISTERED I Y N FEE CURREN I Y/ N I l�/j,�/c / ",/ Address I ! 1 License # I PLUMBER COMPANY I SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N I Address I 1 License # I MECHANICAL COMPANY I SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y / N I Address I License # I OTHER COMPANY SIGNATURE REGISTERED Y / N I 1 FEE CURREN I Y/ N I Address I 1 License # 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/ 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, 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 $7500) ** 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 if shingles Sewers Service Upgrades NC Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW