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,.�.. �,,,, ,.,,..., vity vi �.cNt�yiinua rci�inir��Niwauvi� � �..-,.�.,-,.,�-.,��.� <br /> . � Buliding Department <br /> {�✓�o �c <br /> Date Received � �7/ phone Contact for Permittin �d�3 Z _ `�'9�- <br /> Owne�'s Name l� f�� �-- Owner Phone Number �3 -3��`'- Q7Z <br /> Owne�'s Address � p b �� �S� Owne�Phone Number —� <br /> Fee Stmple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRE33 3� T�� j S A�- Z�-P�i���i�JS �L 33 SY7.� LOT# / �3 <br /> SUBDIVI310N F� ��`T s pARCEL ID# 3-�Z.�-2-��D��R 'C�jp - ��1'30 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT Q SIGN Q MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME Q STEEL Q OTHER <br /> DE3CRIPTION OF WORK '�C.Y�AClL � �,J cIp �J S�L �;Z, � � �,, ���b�� � - <br /> BUILDINO 31ZE 3Q FOOTAGE HEIGHT <br /> 0 BUILDING �$ -����, Q � VALUATiON OF TOTAL CONSTRUCTION <br /> 1 <br /> 0 ELECTRICAL � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> 0 PLUMBINO $ 2�Z3 <br /> � r J <br /> Q MECHANICAL �� VALUATION OF MECHANICAL INSTALLATION <br /> 0 GAS Q ROOFIN(3 � SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS (� � FLOOD ZONE AREA QYES ONO <br /> � <br /> � � � � <br /> BUILDER �,��` COMPANY -�e� , , <br /> SIGNATURE �`� REGISTERED N FEE CURRENT Y/N <br /> Address � �t $1 �q'3 1 � F(,3 Z$7 g Ucense# C���5�{-1� <br /> ELECTRICIAN 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 /> MECHANICAL COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRENT Y/N <br /> Address L(cense# —� <br /> OTHER <br /> SIGNATURE COMPANY <br /> REOISTERED Y/ FEE CURRENT � Y/N <br /> Address l.icense# —� <br /> RESIDENTIAL Attach(2)Piot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new constructlon, <br /> Minimum ten(10)work(ng days after submittal date. Requlred onsite,ConstrucUon Plans,StoRnwater Plans w!Silt Fence installed, <br /> Sanitary FacfllUes&1 dur,�pster;Site Work Permit fo�subdivisions/large pro)ects <br /> COMMERCIAL Attach(3)sets of Butlding Plans;(�i)set of Energy�orms.R-O-W Perm(t`For new construcUon. <br /> Mtnimum ten(10)werk(ng days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/S(It Fence Installed, <br /> Sanitary FaGlides&1 dumpster.Site Work Permit for all new proJects.All commerclal requlrements must meet compliance <br /> 31GN PERMIT Attach(2)sets of Engineered Plans. <br /> "*"PROPERTY SURVEY required for ali NEW constructlon, <br /> Dlrections: <br /> Fill out appllcatlon completely. <br /> Ovmer&Contractor slgn back of appiicaUon,nota►ized <br /> If over s2500,a Notice of Commencement Is�equired. (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 /> 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 roadways..needs ROW <br />