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a�3-7so-oo2o City ot Lephyrhiils F'ermit Application rax-tfl:i-itSU-UU'L1 <br /> Buiiding Department <br /> Date Received Phooe Contact for Permlttln J�J c���] - �f �f �� <br /> Owner's Name � l�"�l d t� �P4 Owner Phone Number �� .�" � 7 h �.�� � <br /> Owner's Address � n � � �� � S � Owner Phone Number ,�f �'J � � �� �' G � � �P <br /> Fee Simple Titleholder Name s/�'�� L Owner Phone Number � <br /> Fee Simple Titleholder Address �� �- <br /> JOB ADDRESS ��"T� E' LOT # �� <br /> SUBDIVISION , PARCEL ID# � z ' ^��� 2 '` ��' d�' -" C C� l U�" G3 G <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM [5Z� OTHER F' � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �� STEEL Q <br /> DESCRIPTION OF WORK .1NS �`Jf `f 7 r ��% r ��C� /� i�' f.' � 2 %J-Z'� S <br /> BUILDING SIZE �--� SQ FOOTAGE�� HEIGHT �_� <br /> QBUILDING $ �S �'7 �G VALUATION OF TOTAL CONSTRUCTION <br /> ! <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �/�� / <br /> � � I <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � COMPANY <br /> SIGNATURE _ ��isTeReo 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 <br /> Ucense # <br /> MECHANICAL � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address Ucense # �- � <br /> OTHER COMPANY �� � ����� � c..�L� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ��� � �l� �f : �,� �'-� � �(, U 5 License # �� � I � ! 7 Z� <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 (nstalled, <br /> Sanitary Facilitles 8 1 dumpster; Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life 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 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> " SURVEY required for all NEW construction. <br /> Dlrections: <br /> Fill out applicaGon completely. <br /> Owner & Confractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement is required. (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 /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on publlc roadways..needs ROW <br />