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a�saso-oo2o City ot Lephymills rermit App�ication rax-��;�-�au-uuz, <br /> 8uilding Department <br /> Date Recefved � � <br /> Phone Contact for Permltttn _ <br /> Owners Name �7Qv 1� ipPV � Owner Phone Number �� 3 3� S �o� �i <br /> Owner's Address C� � J� / ��� S I Owner Phone Number 3� S � 1 G <br /> Fee Simple Titleholder Name Owner Phone Number �— <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS l4 � SS ��� S r LOT # �� <br /> SUBDIVISION / ��� � , PARCEL ID# <br /> (OBTAINED FR�OM pROPERTY T riCe) DEMOLISH <br /> WORK PROPOSED e NEW CONSTR ADD/ALT � SIGN <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM C� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME STEEL � <br /> DESCRIPTION OF WORK C� 1e �Z� �T � �j ?G 1� (_a rv 6 <br /> BUILDING SIZE SQ FOOTAGE C] HEIGHT C� <br /> �]BUILDING <br /> l� $ � 6 d0 � VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE <br /> Q PROGRESS ENERGY Q W.R.E.C. <br /> Q PLUMBING $ f I� I�'" <br /> QMECHANICAL $ VALUATION OF MECHA � <br /> NICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY <br /> �] OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � /� <br /> SIGNATURE '` � y COMPANY ^�� � f� 2 � N� <br /> REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' License # r <br /> ELECTRICIAN COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � <br /> PLUMBER COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address <br /> License # <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address � <br /> License # � <br /> OTHER <br /> 51GNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # —� <br /> ZESIDENTI 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, Constructlon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Work Permit for subdlvisions/large projects <br /> :OMMERCIAL Attach (3) complete sets of Bullding Plans plus a Ufe Safety Page; (1) set of Energy Forms. R-O-W Permlt 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 8 1 dumpste�. Site Work Permit for all new projects. All commercial requirements must meet compliance <br /> iIGN PERMIT Attach (2) sets of Englneered Plans. <br /> ""*PROPERTY SURVEY required for all NEW construction. <br /> Ilrections: <br /> Fill out application completely. <br /> Owner & Confractor slgn back of applicatlon, notarized <br /> If over =2500, a Notice of Commencement is requlred. (A/C upgrades over s7500) <br /> ' Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> �VER THE COUNTER PERMITTING (Front of Applicatlon Onty) <br /> eroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />