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a�aaso-oo20 (;ity ot Lephyrnins rermi[Hppncduu�� � ���•� ��� �--• <br /> Building Department <br /> Date I�eceived , Phone Contact for Permittin 1 r <br /> Owner's Name �� � S Owner Phone Number <br /> Owner's Address `'I �. Owner Phone Number� � <br /> Fee Simple Titleholder Name � Owner Phone Mumber[ <br /> Fee Simple Titleholder Address <br /> JOB ADDRE33 i���� �I' - � - �.L]�*� • � LOT# �� <br /> SUBDIVISION �t�o �'c �`��S -+- PARCEL ID# I�•o��'oZI• ��•� •W�b <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN Q MOVE Q DEMOLISH <br /> e INSTALL B REPAIR �•��f <br /> PROPOSED USE � SFR Q COMM OTHER [_ <br /> TYPE OF CONSTRUCTION BLOCK � FRAME Q STEEL Q OTHER <br /> DESCRIPTION OF WORK QO IS �S O� � <br /> BUILDING SIZE �_� SQ FOOTAGE�� HEIGHT � <br /> � BUILDING $ �- VALUATION OF TOTAL CONSTRUCTION <br /> Q ELECTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> Q PLUMBING �$ � <br /> � 21 Z,2� <br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> Q GAS ROAFING 0 SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATI NS FLOOD ZONE AREA QYES QNO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# � <br /> ELECTRICIAN 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 /> Address License# <br /> MECHANtCAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address ' License# �- � <br /> OTHER COMPANY � ' <br /> SIGNATURE REGISTER�D Y/ N FEE C NT 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 construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)sets of Building Plans;(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,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 7 dumpster.Site Work Permit for ali new projects.All commercial requirements must meet comptiance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contracto�sign back of application,notarized <br /> If over;2500,a Notice of Commencement Is requlred. (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 Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public�oadways..needs ROW <br />