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s�s-7ao-oo2o Cifiy ot �epnyrnnis r�r,���� HNN���a«�>> � <br /> • • Buiiding Deparfinenf <br /> Date Received Phone ConfacE for Permitting f�3 ��� , s'��I <br /> - r.rrrt - - rr <br /> Owner's Name T� � Owner Phone Number � <br /> Owner's Address 3 Qs� � �W 0( e/�/J�� Owner Phone Numher <br /> Fee Simple Titleholder Name • Owner Phone Number <br /> Fee Simple Titleholder Address � <br /> JOBADDRESS G�4.�XrQ. !'caf 4 � • � LOT#k �� <br /> SUBDIVISION • �X�/Ps.�� (it'L�V PARCEL ID# a y-� -�-��� �d -� v <br /> . (O[3TAINE� FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED ' NEW CONSTR ADD/ALT � SIGN � MOVE Q DGMOLISH <br /> � 1NSTALL e R�PAIR <br /> PROPOSED USE' . � SFR ' �• COMM 0 OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK � FRAME �. 0 STEEL 0 OTHER <br /> DCSCRIPTION OF WORK C O/� • <br /> BUILDINGSIZE �3��f 37 1 SQ�OOTAGE 7�� � HEIGh1T <br /> '[�] BUILDING $ s . , p �1 VALUATION Of- TOTAL CONSTRUCTION <br /> 0 ELECTRICAL $ AMP SERVICC 0 PROGRESS ENERGY W.R.E.C. <br /> ' ' � �� ����8� ���l,l��"r <br /> � PLUMBING $ (81�� 75��' �,,,� <br /> � ��c �-�-�24-7a�� <br /> MECNANICAL � VALUATION OF MECHANICAL INSTAL TION <br /> � GAS � ROOFING 0 SPECIALTY � OTHCR , ( J/��� <br /> - LOOR ELEVATIONS PLOOD ZONE AREA DYES ONO � <br /> �INISHE� F <br /> BUfL�ER �� s � MPANY �GC./� � � � � � <br /> SIGNATURE � RGGISTERED Y/ N FEE CURRENT Y/ N <br /> Address Q /S � � � Z� ` � . License # <br /> 6LECTRICIAN • COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address � License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Add�ess License # C <br /> MECHANICAL ' COMPANY <br /> SIGNATURE • • REGISTERED Y/ N �FEE CURRHNT Y/ N . <br /> Address . License # <br /> OTHER � COMPANY ' <br /> SIGNAl'URE RCGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � � <br /> RESID�NTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br /> Mfnimum ten (10) worl<ing days after submittal date. Required onsite, Construction Plans Stormwater Plans w/ Silt Fence instalied, <br /> Sanitary Facilities & 1 dumps�er; Site Worlc Permit for subdivisions/large �rojects <br /> COMMERCIAL Attacli (3) complete sets of Building Plans plus a Life Safery Page; (1) set of Energy Forms. R-O-W Permit for new construction. <br /> Minimum ten (10) woricing days after submittal date. Required onsite, Construction Plans, Stormwater Plans w! Silt Fence installed, <br /> Sanitary f-acilities & 1 dumpster. Site Worl< Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attaeh (2) sets of Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. ' • <br /> -F4-FI-f-f-1-H-H-I+N-1-1 i°i°f-i-i-i°1-i-��-Ff-1-I-}-f-1-H-1 • � � , •-n_r�_�-i-i-Fi°� �-4-F1-}-I-1-1-H-1-f-H-H-I-H-1-H-I-N-I-1-l-1-H-hl-Fl-M-hl-1-f-I-li-1-I-I-1-1-FI-1-H-1-i-I � • , • • • • : � • • • : , ," � <br /> Directions: , <br /> Fill out application completely. ' <br /> Owner & Contractor sign back of application, notarized ' <br /> If over $2500, a Notice of Commencement is required. (A!C upgrades over $5000) <br /> ** Agent (for the contractor) or Power oflAttorney (for the owner) wouid be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) ' <br /> Reroofs Sewers Service.Upgrades A/C Pences (PlotlSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways.:needs ROW <br />