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a�a-�so-oozo Lity ot [ephyrnilis rermit App�ication t �1� ' rax-�s�a-itsu-uu�� <br /> Building Department �(/ � � ��(� <br /> , �� � ,� <br /> Date Received Phona Contact for Permitun — `"�✓ <br /> Owner's Name i v � (f �� Z- � fc Owner Phone Number <br /> Owner's Address 3 7 1`� � k r�'^ {� L" Owner Phone Number �— <br /> Fee Simpie Titleholder Name � Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � � pX ✓ n T� LOT # � <br /> SUBDIVISION � � il C� Q ti. K� , PARCEL ID# a 3-Z �- z r- o r z� -d�' �o� -� c� `� �U <br /> (OBTAINED FROAA PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK /�-�- `"� d�l f �` l Q1 �� c�,,� 7_ M ��� 3�� <br /> BUILDING SIZE � SQ FOOTAGE� HEIGHT —� <br /> QBUILDING $/ ��� J VALUATION OF TOTAL CONSTRUCTION <br /> l� <br /> QELECTRICAL � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL �� VALUATION OF MECHANICAL INSTALLATION <br /> QGAS (� ROOFING Q SPECIALTY 0 OTHER <br /> T <br /> FINISHED FLOOR ELEVATfONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' Llcense # —� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # —� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N � <br /> Address License # �— � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address Lice�se # � <br /> OTHER � � COMPANY � `t� 7� � � � � <br /> ��� �� � <br /> SIGNATURE _ Resis�Reo Y/ N FEE CURRE� / N <br /> Address 3 a) D s��e�— o(cj�x 1 l.Icense# CGO,S 5'� 7 <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Pla�s; (1) set of Energy Forms; R-O-W Permlt for new wnstructlon, <br /> Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary FaGlities 8 1 dumpster; Site Work Permit for subdivisions/larae oroiects <br />