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8�aaso C:ity ot Lepnyrnills Nermit Application Fax-S73-7S0-DU21 <br /> Building Department <br /> Date ReCelved '` —' phone Contact for Permittin — <br /> Owner's Name � P, i V U i'� Owner Phone Number 77v `� <br /> Owner's Address fi � Owner Phone Numbe� <br /> Fee Simple Titieholder Name � Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> uJOB ADDRESS I�� y � "I LOT # � <br /> SUBDIVISION � � . PARCEL ID# <br /> (OBTAINED FROIiA PROPERTY TAX NOTICE) <br /> Q�VORK PROPOSED � NEW CONSTR B ADO/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE [�] SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> �DESCRIPTION OF WORK C�- e� C� �� r 1 " ` �+� <br /> BUILDING SIZE SQ FOOTAGE � HEIGHT <br /> QBUILDING $� O �O I O� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ / /�C!-�V �� <br /> T. 4 , ,� r�'� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION v" � <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER 'I� �� I(1 �� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � <br /> .�� <br /> BUILDER � COMPANY �I � rn`e O w` f'e � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURREP Y/ N <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N � <br /> Address Ucense # —� <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 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 subdivisions/large projects <br /> COMMERCIAL Attach (3) complete sets of Buliding Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new wnstruction. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary FaclliUes 8 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 fo� all NEW construcUon. <br /> Dlrectlons: <br /> Fill out application completely. <br /> Owner 8 Confractor sign back of applicatlon, notarized <br /> If over;2500, a Notice of Commencement is requlred. (A/C upgrades over i7500) <br /> '" Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of ApplicaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />