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o��-�a�-���� v��y v� �cNiiyi�n�w � �������.��, r ,�..w.,.,,� ��� ` <br /> Building Departrnent $ I � � 6 � � � S � � �/�� �}, <br /> %J <br /> Date Ftecelved ' Phone Contact for Permittin - � <br /> Owner's Name Q D C� Owner Phone Number `"'Fa�J °$ �� <br /> .� <br /> Owner's Address � Z �/ Owner Phone Number - _ <br /> Fee Sfmple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �� 7 Z l/'1 S f �X ''L r s��. . 3� � LOT # � <br /> SUBDIVISION 1fi� Dt'Z�n.7����s PARCELID# ����-�v�21 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT Q SIGN Q MOVE Q DEMOLISH <br /> INSTALL REPAtR <br /> PR(�'OSED U3E Q SFR 0 COMM Q OTHER T � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q OTHER <br /> DESCRIPTION OF WORK !/3G� �' f ' � � � ZQ r � �-D �o f "� � 1 � � <br /> BUILDING SI2E C � SQ FOOTAC3E �_ HEIGHT <br /> Q BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> .ZZ �� r U C'J <br /> 0 ELECTRICAL � � AMP SERVICE -, Q PROGRESS ENERGY [] W.R.E.C. <br /> Q PLUMBING ($ � ^ �� ( <br /> � _� ( � <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> 0 GAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHI�D FLOOR ELEVATIONS (� � FLOOD ZONE AREA QYES QNO <br /> � -Z�o9' S O/��ICA <br /> � l� e er avw� Z� <br /> BUILDER � COMPANY -�-C _�1 , <br /> SIGNAI'URE REGISTERED N FEE CURRENT Y/ N <br /> Address C> C7 x 3 3 DIZI l -/' �� License# C����"� � <br /> ELECTRICIAN COMPANY <br /> SIGNA7URE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # T � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � —� <br /> OTHER COMPANY <br /> SiGNATURE REGISTERED Y/ FEE CURR6NT Y/ N <br /> Address License # �— <br /> ittii-Ftt <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construcdon, <br /> Mfnimum ten (10) woricing days after submittal date. Required onsite, Construction Plans, Stormwater Plans w! Silt Fen�e installed, <br /> Sanitary Facflities & 1 dumpster; Site Work Permit for subd(visions/large projects <br /> COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. t2�0-W Perm;t�for ne�N construcGon. <br /> Minimum ten (10) working tlays after submittal date. Required onsite, Conshuction Plans, Stormwater Plans w/ Silt Fence Installed. <br /> Sanitary FaciliUes & 1 dumpster. Site Work Permit for all new projects. All commerclal requirements must meet complfance <br /> SIGN PERMIT Attach (2) sets of Engtneered Plans. <br /> "•"PROPERTY SURVEY required for all NEW construcNon. <br /> -„��������� <br /> W ii41i� ill T I��f11111�71�1��IR I <br /> ■�iLi�1111Li11iii141YLIJ111lIJ <br /> Directions. <br /> FIII out appl(catlon completely. <br /> Owner & Contractor stgn back of applicadon, notarized <br /> If over;2500, a Notice of Commencement is required. (A/C upgrades over s5000) <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 Applicatlon Only) <br /> Reroofs Sewers Service Upgrades A/C Fences (PIoUSurveylFootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />