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o�o-�ov-w�v �.��y �� �cN��r������.� � a������r,r���.,�.�.�..�� <br /> Buflding Department <br /> ✓Y►B oJ� �A <br /> Date Raceived �� 13_ �3 phone¢ontact i.or Pe Ittin 13 2�4 _ '�'1965 <br /> Owner's Name Ci�� M u e,ll eR (i u�li,,�l pwner Phone Numbor �t"S - 7 &'7� ` �/`3 Y <br /> Owner's Address Owner Phone Number �1 O� - �.88 - `�`t�8 <br /> Fee 8imple Titleholder Name � Owner Phons Numbsr � <br /> Fee 3lmpie Tftleholder Address <br /> JOB ApDR�SS �� 3 �{ 4 7 37 C'/�f� ST ZeP�,a y l��!/S �L 3 3 S�/� LOT* � <br /> SUBDNI310N M�t=,�L�S A Gl�� PARCEL ID# i �°2�`�� - b a�fl 'G�'3 C'o�9 - fj C��'Q <br /> (OBTAINEb fROM PROPERTY TAX NOTIC�E) <br /> WORK:PRR�AO$ED NEW CONSTR ADO/ALT [� SION Q [� DEMOUSH <br /> INSTALL 8 aEPA1R <br /> PROR�BED.USE Q SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �] STEEL Q <br /> DESCRIP'f10N OF WORK l�c�'�/�C� / doc�2 i,.,v�l + �'J /„��,�/U/c.,1 t,e,v +1'S S:t,��5 i t� �-"L f 1 Z t7�, f <br /> BUILDIN(i SIZE 8Q FOOTAOE�� HEI(iHT ] �` ����, r <br /> �BUILDINO a 3�o�` � -3 VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROCiRESS ENERGY Q W.R.E.C. <br /> QPLWMBINO � �L I �]Q�� <br /> f� .�/ � <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QOAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> G C��.�1 1'�L'l'� <br /> BUILDER �COMPANY i.Or,�-CS �loM�, Gea��2� �n!t- <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address o �o� � �'3 ��'A�d�' �z���' License# C.6G I SO ��-� <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> PLUMBER COMPANY <br /> 810NATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Addresa License# r `� <br /> MECHANICAL COMPANY <br /> 31�3NATURE REGI3TERED Y/ N FEE CURItE� Y/N <br /> Address Ucense# � <br /> OTHER � COMPANY <br /> SI�NATURE REOISTERED Y/ N FEE CURRE� Y/N <br /> Address License# I <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)aet of Energy Forms;R-O-W Pertnit for new constructlon, <br /> Minfmum ten(10)working days after submittal date. Required onsite,Constructlon Pians,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary FadlfUes a 1 dumpster;SEte Work Pertnft for subdfvlslons/iarge proJects <br /> COMMERCULL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new constructlon. <br /> Minimum ten(10)work(ng days after submittal date. Requlred onsite,t;onstrucrion�lans,Stormwater t ians wi�iii Fe�ca insiaiied, <br /> Sanitary Fadlitles 81 dumpster.Site Work Pertnit for all new projects,All commercial requirements must meet compliance <br /> SION PERMIT Attach(2)sets of Engfneered Plans. <br /> •""'PROPERTY SURVEY required for all NEW construcUon. <br /> Directions: <br /> Ftll out applicatlon completely. <br /> Owner&Contractor sign back of applicatlon,notarfzed <br /> If over f2500,a Notice of Commencement is roqulred. (AIC upgrades over;7S00) <br /> "' Agent(for ihe contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTINO (Front of Applicatlon Only) <br /> Reroofs If shingies Sewers SeMce Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Drlveways-Not over Counter it on pubflc roadways..needa ROW <br />