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"„' ""'"""' vi�y VI LG�JIIy111111.7 r�iiiiii r�N�iwauv�i �a..-..�,,,,,,,,,,,,,�.� <br /> Building Department <br /> 7'�6Nt�H <br /> Date Received � � � r/�, Sr3 `L.(oc! _ ��65 <br /> Phone Contact for Permittln <br /> Owner's Name 212 C � Owner Phone Number g�.3- 7 9 - �.3(o g <br /> Owne�'s Address �7�'S/ � $Sp� �u d Owner Phone Number <br /> , <br /> Fee 3lmple Titleholder Name Owner Phone Number �� <br /> Fee Simple Titleholder Address <br /> JOB ADDRES8 S 1 p S SO�YL I ���h�//2,Y1! ( (� 1=� �.3S�L LOT# � <br /> SUBDIVI310N f} � �pS r+1 � 'C�-• PARCEL ID# �S`�"Z'� "017� ' OSOO -ODGO <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT Q SIGN Q MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED U8E Q SFR Q COMM [� OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME Q STEEL Q OTHER T� <br /> DE3CRIPTION OF WORK r.l-'��- � 0 2 N c'tS Sr��S�Z� L gZ2g�� -}-,, � _ <br /> BUILDIN(3 81ZE SQ FOOTAGE HEIGHT <br /> [� BUILDING �$ ,��/3' � r VALUATION OF TOTAL CONSTRUCTION <br /> � ./.�� <br /> [� ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C. <br /> 0 PLUMBING $ <br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �' <br /> 3���� <br /> [� GAS Q ROOFINO �] SPECIALTY <br /> Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA OYES [�NO <br /> BUfLDER �^�� � � d <br /> SIGNATURE � � 1 COMPANY +e� , . <br /> REGISTEREO N FEE CURRENT Y/N <br /> Address � �d�l $j 9'q 3 � O FL 3Z�S7$ Ucense# C�.�0��-f-(� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N F'EE CURRENT Y/N <br /> Address License# � <br /> PLUMBER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRENT Y/N <br /> Address (�-- <br /> License# � <br /> MECHANICAL <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRENT Y/N <br /> Address � <br /> License# <br /> OTHER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ FEE CURR6NT Y/N <br /> Address <br /> License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permtt for new constructlon, <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facfiitles 8�1 dumpster;Site Work Permit for subdtvisions/large proJects <br /> COMMERCIAL Attach(3)sets of Building Plans;(1)set of Energy Forms, R-O-W Permit`for new construcUon. <br /> Mtnimum#en(10)working iiays a!tgf c'1Fjl�7I!�3I d3t9. RBGUIfd(�OI1SIt8,ConscrucUon Plans,Stormwater Plans w/Silt Fencs installed, <br /> Sanitary Facilitles&1 dumpster.Site Work Permit for all new pro)ects.All commercial requirements must meet compllanCe <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&Contractor stgn back of appllcaUon,notarized <br /> +• If over;2500,a Notice of Commencement Is required. (A/C upgrades over E5000) <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 />