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813 - 780 -0020 City of Lepnyrnnls I HNNnt.,auvi i ( 2 <br /> Building Department 1 1 7 <br /> Date Received a .1 Phone Contact for Permitting <br /> ' <br /> Owner's Name '(�(,[A-1 Elie Owner Phone Num. -r Z, 3 77 4. ell5 3 !j <br /> Owner's Address i5� L 41ij* /7f /14 407 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS J O p <br /> (0 5 / 7 I /7 y - LOT # l c3 <br /> 00000. ' /TEO <br /> SUBDIVISION /CQ 0 r PARCEL ID# ■ • - = .1 1 1 - 1 k i <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED • NEW CONSTR ADD /ALT - SIGN I I MOVE I I DEMOLISH <br /> INSTALL REPAIR �.__:› <br /> PROPOSED USE I I SFR I I- COMM I I OTHER I I <br /> TYPE OF CONSTRUCTION I I BLOCK I I FRAME . STEEL �I OTHER I Aei t ,�1i,Y I <br /> '; -01 4`u m%" ►czY, -, /'1a Cx•)4' / a /gym ir-> Shd S 154. <br /> n <br /> DESCRIPTION OF WORK Y ' - _ - _ - _ 41. ) ' <br /> BUILDING SIZE • SQ FOOTAGE HEIGHT <br /> BUILDING $ 5 © c " VALUATION OF TOTAL CONSTRUCTION <br /> 1 1 ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY I W.R.E.C. <br /> I I PLUMBING $ <br /> I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> I 1 GAS 1 1 ROOFING I I SPECIALTY I I OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES I INO <br /> y 1 <br /> BUILDER. 1 ‘ 4 COMPANY 0 I A 0 r 7/- C C <br /> SIGNATU h)46.4 tL J �, V REGISTERED 1 Y / N I FEE CURRENT 1 YIN 1 <br /> Address 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 I Y/ N I FEE CURRENT I Y/ N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address . License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y / N j FEE CURRENT I Y/ N I <br /> • <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. (NC 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 NC Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways.:needs ROW / /l6 le-1 / /6 / <br /> O /f' d* •.- 't ->--- Al 4 ,' A- 9: , e C it° 5' 1 e /7 <br />