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�'�-���-���� l�liy �T G@pflyff1111S f e(f111L HpPIICB[IO� rax-oio-�ov-w�� <br /> Building Department <br /> �'V1 D n� i C.q� <br /> Date Re,cel ed" , 2� � � � f 3 Z�O � G t G l fo 5 <br /> Phone Contact for Permitt(n <br /> + ' st�ta <br /> Owne�'s N me J� l U�Ol� A� �� Z Owner Phone Number 35 � s/ - ! 9 <br /> Owner's Address J ��� �-7�1 i9'U�. 'z 1 � i�s Fi 33Sy Owner Phone Number C__ <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee SimplelTitlehoider Address <br /> JOB ADDRESS ��O 1 � ���� 14VE'_ �-eph Y '� � �CS ��.- �j3 ��j�'� LOT # C�� i9-2C7 <br /> SUBDIVISION ��y dT ��m(Q.�,�l(S PARCELID# �('�' O� - ��o��Q 'OI $� <br /> (OBTAINED FROM PROPER7Y TAX NOTICE) <br /> WORK PRaPOSED B NEW CONSTR e ADD/ALT Q SIGN [� MOVE Q DEMOUSH <br /> INSTALL REPAIR <br /> PRphOSEO USE Q SFR � COMM Q OTHER �N c� =i� �,411 <br /> TYPE OF CQNSTRUC7!ION � BLOCK Q FRAME Q STEEL Q OTHER �� <br /> DESCRIPTIQN OF WOIRK ��STAI 1 I gp` D� U�,ti�/Z, �o ��igL F�nJt� � <br /> BUILDING $IZE SQ FOOTAGE HEIGHT �� <br /> � <br /> [�J BWILD�NG $ p� ` 1� VALUATION OF TOTAL CONSTRUCTION <br /> �� f <br /> Q E4ECTRICAL $ � AMP SERVICE ����] PROGRESS ENERGY Q W.R.E.0 <br /> Q PIIUMBING ($ S�C,c� /y�(1✓1� C�L <br /> � I " �}-Z �-%( � <br /> M�CHANICAL $, � VALUATION OF MECHANICAL INSTALLATION �,� � la � �np,, s <br /> Q GAS Q ROOFING � SPECIALTY Q OTHER /� � <br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA QYES QNO <br /> - 269 - S on� i c' ,q <br /> BUILDER I � I � � - ev rL� —� <br /> (iOMPANY -F��� S� <br /> SIGNATURE REGISTERED N FEE CURRENT Y/ N <br /> ,4ddress b p X � 3 D�Z.I f_�% '.3Z$7��' ucense # � ���L( <br /> ELECTRICl/�N COMPANY _� <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address Llcense # � _� <br /> PLUMBER COMPANY _� <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # _� <br /> MECHANICA�. COMPANY _� <br /> SI.GNATURE REGISTERED Y I N FEE CURRENT Y/ N <br /> Address License # _� <br /> OTHER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # _� <br /> RESIDENTIAI� Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construcdon, � <br /> Minimum ten (10) working days after submittal date. Required onstte, Constructlun Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary FaciliUes & 1 dumpster, Site Work Permit for subdlvtsions/large proJects <br /> COMiL7ERC�At Attach �3} sets of Buiiding Pians; (•I ) set of Energy Forms. R-O-W Permit'for new consUuctlon. <br /> Minimum ten (10) workfng tlays after submittal date. Required onsite, Constructicm Plans, Stormwater Plans w/ Silt Fence Installed, <br /> San(tary FaciliGes & 1 dumpster. Slte Work Permit for all new projects. All comm�rcfal requirements must meet compllance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> """PROPERTY SURVEY required for all NEW construcdon. <br /> Directions: � <br /> FIII out applicaUon completely. <br /> Ovmer & Contractor sign back of appllcadon, notarized <br /> if over E2500, a Notice of Commencement is requi�ed. (A/C upgrades over a5000) <br /> '" Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> nVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />