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s�s Gity ot Lephyrhilis Nermit ApplicaUOn rax <br /> Building Department <br /> Date Received � � Phone Contact for Permittin — <br /> Owner's Name �'� Owner Phone Number ���� d� <br /> Owner's Address �� - � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> c � JOB ADDRESS �• � LOT # <br /> SUBDIVISION � , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICEj <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDING SI2E SQ FOOTAGE � HEIGHT �� <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> LECTRICAL $�� v � AMP SERVICE �G �PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y! N <br /> Address ' License # <br /> ELECTRICIAN COMPANY �� �---- <br /> 51GNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address � l( � 3�Z Lice�se # ��! ��d j Q'� � <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 License # � —� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permlt for new construclion,. <br /> Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Work Permit for subd(visions/large prolects <br />