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�s�irrnu-wzu l�lly UI GC(Jtiy�imis rtsitni�r�NNin.a�w�� •-••-•- •-- ---- <br /> • ` Building Department <br /> M '� ,- <br /> Dat•Received Phone.Contact for Permittin � Z 5► S"� _ <br /> Owner's Name G L Owner Phons Numbsr � 3 - -�00 C� <br /> Owne�'s Address 7� ZS �*�1a� P Owner Phone Numbar � <br /> Fsa Simple Tklaholder Name Owner Phone Numbsr <br /> Fee Simple Titleholder Address <br /> JOB ApDRES3 "Z i �. i Cf 5 �L '�3 S�f ! LOT# 3 i <br /> SUBt�l�til$iQN �C.. PARCEL ID# �� `Z — 2 -- O 1 C o �-00�aa � O 3 f C <br /> (OBTAINED FROM PRdPERTY TAX NOTIffiE) <br /> yypR!(�PR�Ppg£D e NEW CONSTR 8 ADD/ALT [� SIGN Q Q DEMOUSW <br /> INSTALL aEPAIR <br /> PROROSED.USE Q SFR � COMM [� OTHER <br /> TYPE OF CON87RUCTlON Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTlON OF WORK t 2� � a� �� /'��� � I.� 'T ��T'C. <br /> BUILDINti 81ZE �_� 3Q FOOTA(iE� HEI(iHT <br /> QBUiLDING S �5...�I � VALUATION OF TOTAL CONSTRUCTION <br /> [�ELECTRICAL (� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C: <br /> � <br /> QPLUMBINC3 S <br /> QMECHANICAL a VALUATION OF MECHANICAL INSTALLATI�N <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> G C��R.d �-� <br /> BUILDER COMPANY f.Ow-e �1cMt GeNT�2�' 'nl�. <br /> SIGNATURE REGISTERED Y/ N �e Curt�� Y/N <br /> Address � �O� � Q� ��A�d`� �t'��� Ucense# ��oG � .s d ��"1�� / I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# � <br /> PLUMBER � COMPANY <br /> 810NATURE RE013TERED Y/ N FEE WRREt� Y/N <br /> Addross Ucense# <br /> MECHANICAL COMPANY <br /> $�(3(�j(J(� REGI3TERED Y/ N FEE CURRE� Y/N <br /> Address License# I � <br /> OTHER COMPANY <br /> 31(iNATl1RE REOISTEREQ Y/ N FEE CURRE� Y/N <br /> Addresa L(cense# � � <br /> RESlDENTUi. Attach(2)Plot Plans;(2)sets of 8uilding i�lans;(1)set of Energy Forms;R-O-W Permit for�ew construcdon, <br /> Minimum ten(10)wo�icing days after subnhittal date. Required onsite,ConsWctlon Plans,Stormwater P�ans w/Silt Fence installed, <br /> Sanftary Fadlitles&1 dumpster,Site Wortc Permit for subdivlslons/large projects <br /> COMMERCIAL Attach(3)complete sets of Buflding Plans�plus a Life Safety Page;(1)set of Energy Forms.R-0-W Pem►ft for new construcUon. <br /> Minfmum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Siit Fence installed, <br /> Sanitary Fadfltles 81 dumpster.Site Work Permit for all new pro)ects.All commercial requirements must meet compllance <br /> 81(iN PERMIT Attach(2)seta of Engineered Plans. <br /> "*"'PROPERTY SURVEY required for ell NEW construcdon, <br /> Dfrections: <br /> FIII out applicatlon completely. <br /> Owner&Contractor sfgn back of appiicallon,notarized <br /> If over�1500,a Notice ot Commencament is roqulrecl. (NC upgrades over i7500) <br /> •' Agent(for the contractor)or Power of Attomey(for the owner)wouid be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI7TINO (Front of Applicatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Drivevrays-Not over Counter if on public roadways..needs ROW <br />