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o��-�o�-���� v��y v� c.vNi�y���n�o ��������.� <br /> Bullding Department <br /> Date Received 3_2 _ Phone Contact fo� Permittin - <br /> Owners Name G � e/�/ Owner Phone Number pL3 ' 7�4 ' 7� 3 <br /> Qwners Address 2 � T p.) � Owner Phone Number �S� 3 " 3��t ��S'3 G <br /> �ee 8lmple Titleholder Name Owner Phone Number � Ti —� <br /> T <br /> Fee 5lmple Titleholder Address <br /> , <br /> JOB ADDRESS C�� �� c�,�Y� �J yTa �� �/Z �P�� �Tr/ �� S{"� 3 3 s Y Z LOR # � <br /> 3UBDIVI310N Sc�U2/�. D( PARCELID#�3° <br /> {OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT 0 SIGN � MOVE [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR 0 COMM � OTHER <br /> TYPE OFCONSTRUCTION � BLOCK � FRAME 0 STEEL � OTHER � <br /> � <br /> DE3CRIPTION OF WORK ���1-t12S �t,,..�. �7 ���}-� �, r„IaTe,2 r�..�.�4�►�tft�e • <br /> BUILDING SIZE � 8Q FOOTAGE HEIGHT <br /> [� BUILDING $ s�Q �/ VALUATION OF TOTAL CONSTRUCTION � <br /> � ELECTRICAI. $ � AMP SERVICE 0 PROGRESS ENERGY ;� W.R.E,C <br /> Q PLUMBING $ � I I r �� � � v� <br /> � � i- i ' � j � <br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION n��YQ�Gt °� <br /> ��� <br /> Q GAS O ROOFINO � SPECIALTY � OTHER '��� <br /> � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE ARE,4 [�YES �NO <br /> BUILDER y t Ifl � • COMPANY �e -L ' 1''���9 � P COI��nA ,� <br /> SIGNATURE / �� L� � L, � I -- REGISTERED FEE CURRENT Y/ N <br /> Address ,3�C� Sc.-fj/t1eT `�� ���rM p�� FL 3`(b T License # y C '� S <br /> HLECTF�ICIAN COMPA�JY <br /> $k(3NATU.RE REGISTE�EO Y/ N FEE CURRENT Y/ N <br /> Addreas � License # �— <br /> RLUAABER COMPANY <br /> 31GNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � <br /> MECHANICAL COMPANY <br /> ' SI.aNATURE <br /> REGISTERED Y/ N FEE CURRENT Y! N <br /> Address Llcense # �— ��� <br /> OTH�R T <br /> SIQNAT.4JRE COMPANY <br /> REGISTER�D Y/ N FEE CURR6NT �� / N <br /> Address � <br /> Llcense # <br /> -.-----�_ <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) sef of Energy Forms; R-O-W Permit for new constructlon, <br /> Minimum ten (10) working days after submittal date. Requlred onsfte, Constructlon Plans, Stormwater Plans w/ �Ut Fenee �nstalled, <br /> Sanitary Facflltles & 1 dumpster; Site Work Permlt for subdivislons/large proJects <br /> COMMERCIAL Attach (3) sets of Bu(Iding Plans; (1) set of Energy Forms, R-4-VV Permit`For new construction <br /> Minlmum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Sllt Fence Installed, <br /> Sanitary Facilidas & 1 dumpster Slte Work Permit for all new pro)ects. All commerclal requirements must meet compllance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> ""PROPERTY SURVEY requlred for all NEW construction. <br /> Directions: , <br /> Fill out applicatlon completely, <br /> Ovmer 8 Contractor stgn back of appllcadon, notarized <br /> If over 52500, a Notice of Commencement is required. (A/C upgrades over a5000) <br /> " Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarfzed letter from owner authorizing same <br /> OVER THE COUNTHR PERMITTING (Front of Applicatlon Only) <br /> Reroofs Sewers Servlce Upgrades <br /> A/C Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on publlc roadways..needs ROW <br />