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a�saao-oo2o City ot Lephymills Nermit Hppucation rax-u�s-iuu-uuz� <br /> Building Department <br /> Date Received Phone Contact for Permittin d �3 �l� — �` � <br /> Owners Name .��GL �✓ �o— Owner Phone Number �Z '� /� <br /> Owner's Address (s� � / Owner Phone Number � � <br /> Fee Slmple Titleholder Name Owner Phone Number � <br /> Fee Simpie Titleholder Address <br /> JOBADDRESS 3 ��p�S� ��.�i d� f'`f' LOT# � <br /> SUBDIVISION �`'�'LS � �� /ll� , PARCEL ID# d Z �'�' �� O�6 0"� � t�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT 0 SIGN Q [] DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK S��V�C� �� �/� GUl"� � ���� G�LJj�bF' <br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT <br /> OBUILDiNG $ VALUATION OF TOTAL CONSTRUCTION <br /> '�ELECTRICAL $ /C�� AMP SERVICE oZ 0"C? � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � 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 �t'� C/��'�z �� C�(�Z� <br /> SIGNATURE REGISTERED N eE CuwtEn N <br /> Address Lice�se# ����,3�� <br /> . <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 /> Address 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 Pians;(1)set of Energy Forms;R-O-W Permit for new construction,. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliUes&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Llfe 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,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 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 required for all NEW construction. <br /> r���n� <br /> i� T�i�irn�ee���r�r����� . <br /> ��a��a�.u.a�a�1�1 liil I 1 J.LLLI <br /> Directlons. <br /> Fill out application completely. <br /> Owner&Contractor sign back of applicatlon,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgrades over;7500) <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 if shingles Sewers S:ervice Upg'rades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public�oadways..needs ROW <br />