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a�saao-oo2o City ot �ephyr�aills Nermit App�ication � r is ,�� rax-uis-i�u-uuzi <br /> Buildincf Qepartment �' <br /> � • °�. <br /> ~'� <br /> Date Received -�i�'�( f phone Contact for Parmlttin - <br /> '�'Owner's Narlre; � � � � ►a 1 l�J �. ,'� Owner Phone Number � 1 � � 77 � - �'S � V <br /> � Owner's A�Idr�ss �� i t� �� � 1 I = Owner Phone Number � <br /> Fae Simple itleh�,d Name r-. ,,,- �"` Owner Phone Number <br /> � . � <br /> , _ ` .�_... .�---- <br /> Fee Simple Titleholder Address <br /> �JOB ADDRESS 3�( ' r9 k E 2 1� G C LOT #� <br /> a6UBDIVISION �� 3EST � F� k� , PARCEL ID# ��� ��� Ov �DI �D ^ v"! <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> r{ WORK PROPOSED NEw CONSTR 8 ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> fDESCRIPTION OF WORK 1 N 5 I L L. �- t,t/ � �'°, <br /> BUILDING SIZE SQ FOOTAGE � HEIGHT �� <br /> p� QBUILDING $�, 4 �� � VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING � � /��y �� }� � { � <br /> �V l.. / !J� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION j_ p�' ` ���/ �� � <br /> Y/ l <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER s' ��� 3 � � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � �Z <br /> � � <br /> (�UILDER ` COMPANY �� M C � �-C_1 AI E <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' License # � <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 Ucense # <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 Pemiit for new construction,. <br /> Minimum ten (10j working days after submittal date. Required onsite, ConstrucUon Plans, Stormwater Plans w/ Silt Fence installed, <br /> __ Sanitary Facilities 8 1 dumpster; Site Work Permit for sutrdivisions/large projects <br />