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s�a City ot Lephyrhilis F�ermit Appllcation rax <br /> Building Department <br /> .r� �..Y <br /> Date Received Phona Contact for Parmlttin l 7�L -- 33/4 <br /> Owner's Name �/ ` r� i'/�� ��S Owner Phone Number <br /> Owner's Address Owner Phone Number � <br /> Fee Simple Titleholder Name � Owner Phone Number � <br /> Fee Simple Tltleholder Address <br /> JOB ADDRESS .5�l�� ��' �'� F� � r� �� ��s F�• LOT # � <br /> SUBDIVISION . PARCEL ID# �� - .2� - D�OD - OyyDO - do/d <br /> (OBTAINED FROM PROPER7Y TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTA�L REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �1ca�'aeL . ZOAq /lo ZO� 3�hNsc bu�«� E� � <br /> BUILDING SIZE � SQ FOOTAGE � HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ �, AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> S Gs" <br /> QPLUMBING $ � � n � � � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> � G <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y! N <br /> Address ' License # � <br /> ELECTRICIAN � COMPANY r� �'�'iC C��c �'�C <br /> SIGNATURE REGISTERED N FEE CURRE� / N <br /> Address A��ic �� z � �/I F/ 33Syo License # �' C 000 /LG 8 � <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 /> Add�ess 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 constructlon,. <br /> Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stortnwater Plans w/ Silt Fence installed, <br /> Sanitary FaciBties 8 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach (3) complete sets of Bullding Plans plus a Ufe Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater Plans w/ Silt Fence installed, <br /> Sanitary Facilitles 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 requi�ed for all NEW constructlon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner & Confractor sign back of application, natarized <br /> If over;2500, a Notice of Commencement is required. (A/C upgrades over:7500) <br /> *' Agent (for the co�tractor) 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 (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> ��n �q ` 75�0 - dQ00 - CX�f 3J 00 -�f �Cr Nmc <br />