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813- 78O -002U city of Lepnyrnitis rermit Application rax- o io- iou -uuc, Building Department - jrq / 4 H Date Received. - _ \ 1 Phone Contact for Permittin , i / 3 is Z 3 — 6 / 6 Owner's Name 7�4, 1; p .l. mo.4.0 I Click le..... Owner Phone Number I? j - - )S1° t 4 1 Owner's Address (e5S 2 ¶i 0 k- `j C,T . Owner Phone Number Fee Simple Titleholder Name I Owner Phone Number Fee Simple Titleholder Address 11 JOB ADDRESS GSS Z Tr .A lc C Z r»- 7 11/-: / Lc P 3.7s ({ Z LOT # SUBDIVISION '0(04ioc Con JO , PARCEL ID# 6 a-•ZG- Z f/ - 6Z /0-OOZ63 16(10 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED I NEW CONSTR E ADD /ALT 1 1 SIGN n ' DEMOLISH INSTALL REPAIR PROPOSED USE '1,1 SFR n COMM 1 ' OTHER I I TYPE OF CONSTRUCTION 1 1 BLOCK n FRAME 1 1 STEEL n I I DESCRIPTION OF WORK ReDier i• -.-l.0 r-1- of c.1L () 'c 9 A ))Or\ /Sier4dI ;I: I 114 BUILDING SIZE SQ FOOTAGE 1 HEIGHT []BUILDING $ VALUATION OF TOTAL CONSTRUCTION [] ELECTRICAL $ AMP SERVICE I 1 PROGRESS ENERGY '—I W.R.E.C. 174PLUMBING $ i / 00 _ ` IQtJ c ,4.0 19 ' 'MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION []GAS '—' ROOFING 0 SPECIALTY I= OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA []YES NO BUILDER COMPANY I SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N 1 Address 1 1 License # I I ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y / N J FEE CURREN ( Y/ N Address I 1 License # I PLUMBER C It'll n C i3v,A5 * 0 s COMPANY I V • . 1.1 • P -c - as /'fC-c�7'► / ►' SIGNATURE �i( REGISTERED 1 N (Ty 1 FEE CURREN I Y / N Address k.#2.4 D ou, l AS Aim . 4 1 •)4c2., A (- , S . i✓(. 3Z'Ny License # I C ,VC-• ac 7 /(F MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREN 1 Y/ N 1 Address ( 1 License # I OTHER COMPANY I SIGNATURE REGISTERED I Y/ N ( FEE CURREN I Y/ N 1 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 A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW