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813 - 780 - 0020 City Ot Lepnyrnnls rel II ut i- ppi autm 111(7'6 <br /> Building Department <br /> Date Received / 34/ Phone Contact for Permitting O/3 - /S <br /> Owner's Name £��e/) COA / Owner Phone Number ill-779- y176 <br /> Owner's Address 9/ "P_Et/ L 7lAge'7L Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> • <br /> Fee Simple Titleholder Address D � , / (9--AL <br /> JOB ADDRESS ad s P 'N tiL LOT # <br /> �/ ,. a _d- "'D * •d00 <br /> (/ t.0062-a-• w 3 �� <br /> SUBDIVISION � ���1 � � I/ '' w'�` PARCEL ID# O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED LJ NEW CONSTR ADD /ALT I 1 SIGN 1 1 MOVE I 1 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR I I - COMM 1 1 OTHER I <br /> TYPE OF CONSTRUCTION 1 <br /> BLOCK 1 I FRAME I I STEEL 1 I OTHER I I <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE a X 613 SQ FOOTAGE , HEIGHT <br /> BUILDING $ c2 Dt) VALUATION OF TOTAL CONSTRUCTION <br /> I I ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY I I W.R.E.C. <br /> I PLUMBING $ <br /> I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION - : ' P E M T SEPAM'E <br /> r r,3 <br /> • I I GAS I I ROOFING I I SPECIALTY I I OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES 1 INO <br /> L /�V � �T L <br /> BUILDER w Lcz <br /> • REGISTERED Y / N FEE CURRENT Y / N <br /> SIGNATURE �f � � I COMPANY � � I <br /> Address 3 79'/a 7'`'` .ore Z.e 6r ,l 33W 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 I <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> OTHER COMPANY • <br /> SIGNATURE REGISTERED I 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-0-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-0-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 /> • <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 NC Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways. :needs ROW <br />