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813- 78o -uozu Uity oT Lepnyrnllis rermit Application 2 0 rax oIriou -uuc I Building Department ( , -' 1 Date Received Phone Contact for Permittin • — }} - � ' ( C LL) � , �� b 1 - � 53---1)11 � Owner's Name )1 I » C �� I �'� � � �� *- Owner Phone Numbe c Owner's Address _2's(7 6 LOk n c3 i it( A C 0 7-€0-,,,,\ h , 1 j S Owner Phone Number 1 Fee Simple Titleholder Name . Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 13 La 1\ 1 1 A 0 n) k I I& FL a3 5 42 LOT # I I SUBDIVISION ( Set ) 1161 , PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED I I NEW CONSTR pj ADD /ALT I I SIGN n n DEMOLISH INSTALL EN REPAIR PROPOSED USE n SFR COMM I I OTHER I I TYPE OF CONSTRUCTION n BLOCK p FRAME I I STEEL n DESCRIPTION OF WORK 1 P C 0 1 f 5 y f T[. ( p rs - Ra- 51,kk- 0 ,;+ g , 'e- 4r iteiks BUILDING SIZE I I SQ FOOTAGE' 1 HEIGHT I M vii runic; ck I VALUATION OF TOTAL CONSTRUCTION nELECTRICAL $ I AMP SERVICE ' n PROGRESS ENERGY n W.R.E.C. r7PLUMBING MECHANICAL I$ I VALUATION OF MECHANICAL INSTALLATION nGAS n ROOFING Q SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA nYES NO BUILDER I COMPANY I SIGNATURE I REGISTERED Y / N FEE I I CURREN I Y N I Address I License # I I ELECTRICIAN I COMPANY I SIGNATURE I REGISTERED I I Y / N I FEE CURREN I Y/ N I Address I License # I PLUMBER I COMPANY I SIGNATURE I REGISTERED Y / N FE CU I J RREN I Y/ N I Address I I License # I MECHANICAL I COMPANY I SIGNATURE I REGISTERED I I �(/ N I FEE CURREN I Y/ N I Address I I I / License # I OTHER � COMPANY IIV //0/)040 /no 6d � f n SIGNATURE I I TERED REG I Y/ N . 1 FEE cuRREn I Y/ N I Address l / S L a X15 i 'sK j Atil - z �CJ1 -1} / i t' /)s 4_ I License # 1 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 A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW