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813 - 780 -0020 UIty of Lepnyrnlils reiirw. 1 <br /> Building Department Tr 1 ( ] 411(/ <br /> Date Received — 2541 Phone Contact for Permitting e / 7I - - 53� <br /> Owner's Name Pent A. /fArQ y Owner Phone Number <br /> Owner's Address 379 24' V/L4t 4 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address �f <br /> JOB ADDRESS 3 7 9 a4 L /j � rL� ,4 . LOT # <br /> SUBDIVISION t4 )//L14 /m . h" • 244 PARCEL ID# /f/ - 6 4 - V — d d/0-/2,c - O/! <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT I I 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 [F[RAME I I STEEL I I OTHER I <br /> DESCRIPTION OF WORK bif' f ft X 7 7 <br /> BUILDING SIZE / 1 x t/ ? SQ FOOTAGE S / 7 HEIGHT <br /> Xi BUILDING $ ) / 5I) aD VALUATION OF TOTAL CONSTRUCTION <br /> I ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY I I W.R.E.C. <br /> I 1 PLUMBING $ W W r.v PE+'Mi T SEAV:CE <br /> I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION f; ~u1G <br /> I I GAS I I ROOFING I I SPECIALTY I I OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES ONO <br /> • <br /> BUILDER /1 / p5 COMPANY �c.�ft V C / (/fl/4I. ...LAC. • <br /> SIGNATURE �+y / � REGISTERED 1 Y/ N I FEE CURRENT 1 Y/ N I <br /> ' <br /> Address �j /5 Fr �[�( � Z -ik/`.4 ,r 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 [ Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y/ N J FEE CURRENT Y/ N I <br /> Address I 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. (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 A/C Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />