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• � � <br /> BUII ' P �,���'� t <br /> � � lr <br /> � <br /> Date Received .- -- 1 <br /> ' � � � � � � � Phone Contact for Permitt g� 7 y� 3� -- � � <br /> Owner's Name �Q � J' �/�(/�r✓ f-�Qi}��r/ «.� �t�j �rPho�s�'Num�.._r. _ ,___._ -g.s� <br /> /� be � �l' ?ys2 $ <br /> Owner's Address �$ ��� � /�i�L°' � h � L Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��`S O � �U � R � j / �- ,jS�� LOT# �� <br /> SUBDIVISION PARCELID# I�" G '-�I' (J��� ` Q�3dC�� "' OOjD <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR B ADD/ALT � SIGN � Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK ��a �� GLH'�7��e � �, '�v (nC e ma �e��iocks c�-r�� ��• a 5 <br /> BUILDING SIZE SQ FOOTAGE /�' �laa HEIGHT <br /> � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ � ���, �Q � AMP SER�I�E Q PROGRESS ENERGY Q W.R.E.0 <br /> � 1 �� � <br /> OPLUMBING $ � ���' ,,l <br /> � � ��j? V <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION '� l �/ <br /> �GAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> 11111111111111111111111111111111111111111111111111111111111111111111 <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address License# ��� <br /> ELECTRICIAN COMPANY a � I-�° J�C {�( �P <br /> SIGNATURE REGISTERED Y FEE CURRE� /N <br /> Address Q � n ��.t+J¢.- �/`V� � �u 3��a� License# % y C�C��3 <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 /> 11111111111111111111111111111111111111111111111111111111111111111111 <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,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page,(1)set of Energy Fortns.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 all new projects.Ali commercial requirements must meet compliance <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 sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> " Agent(for the contractor)or Power of Attorney(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 Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />