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C'IJ-/t!V-VV'LU c;ity ot Gephymiils Permit Appi�cation rnx-o��-i u�-.,v�� <br /> Bullding Department �j , /�� MG� I <br /> �I`�v� � � �o�tiv <br /> Date Recelved �- 3 Phone Contact for Permittin � —� 7�� <br /> Oxener's Mame � Owner Phone Number �� <br /> O+nmer's Address Oemer Phone Number � � <br /> Fee Simpte Titleholder Name Owner Phone Number <br /> IFee Simple Titleholder Addross <br /> JOB ADDRESS W� � LOT� � � <br /> SUBDIVISION ���VQ.���' I�C. I A PARCEL 10� ' 1y' ' "' LJ <br /> (08TAINED FROM PROPERTY TAX NOTICE) <br /> MlORK PROP03ED e NEw coNSTR� ADD/ALT Q SIGN � Q DEMOLISH <br /> INSTALL REPAIR <br /> �ROPOSED USE Q SFR � COMM � OTHER <br /> ?VPE OF COM3TRUCTIOM Q BLOCK � FRAME Q STEEL Q <br /> pESCRIPTION OF MIORK � ` <br /> BUILDIM(3 SIZE �"'T � SQ FOOTAGE I��1 HEfOHT <br /> BUILDING S � VALUATION OF TOTAL CONSTRUCTION <br /> �,ELECTRICAL $y, f��� AMP SERVICE � Q PROGRESS�ERGY Q W.R.E.C. <br /> -J vl1 C�4/C <br /> �PLUMBING $j".�' ��-O �,��p 3L�� <br /> � �J � �ew�;-� � �, — <br /> "�MECHANICAL S 2��r� VALUATION OF MECHANICAL INSTALLATION ��� �/ ���y <br /> `� =�MJV <br /> QGAS � ROOFINC3 '� SPECIALTY � OTHER � �---�—���`�� F�� <br /> FfNISHED FLOOR ELEVATIONS FLO00 ZONE AREA QYES NO 3��P�� <br /> /l� C�n7�iiz�c f— <br /> IBUILDER � COMPANY <br /> SIGfdA7URE �'"`�� Cr REGISTERED Y/ N FEE CURR Y/N <br /> Address �CL� � � � License# �U�C�•� 2 I�� <br /> IELECTRICIAN " COMPANY ' � <br /> �IG(VATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � JK License# ��e�ooa�-q � <br /> P�.UMBER COMPANY <br /> SICiNATURE REOISTERED Y! N FEE CURRE� Y/N <br /> Address � ��J li�lV License# �1 <br /> MIIECHANICAL � ` ~ � COMPANY ^\.,����I � <br /> 31GNATURE ���� � ` REGISTERED Y/ N FEE R � Y/N <br /> Address `� t �1"7�'� /J�(���l�"�' 3 Z�7� Ucense# ,,��l',�.��`�1'�� <br /> OTHER • COMPANY A� � � <br /> 31G(�ATURE �n��' REC313TERE0 Y/ N FEE CUR Y/N <br /> Addross �� . YIU� "1 � Ucense# � � <br /> RESIDENTIAL ABach(2)Plot Plans;{2)sets oi Building Plans;(1)set of Energy Forms;R-O-W Permft for new construction, <br /> Mlnimum ten(10)working days after aubmittal date. Requlred onsite,Construction Plans,StoRnwater Plans w/Silt Fence installed, <br /> Sanitary Fadlities�1 dumpster;Site Work Permit tor subdivisionsJlarge projects <br /> COMMERCIAL Attach(3)eompieta sets of Building Plans plus a Life Safety Page;(1)set oi Energy Forms.R-O-W Permtt for new conshuctfon. <br /> Minimum ten(10)working days after submittat date. Requlred onsite,Constructfon Plans,Stormwater Ptans w/Silt Fence installed, <br /> Sanitary Faciiitfes E�1 dumpster.Site Work Permlt for all new projects.Atl commerclal requirements must meet compliance <br /> SIGid PERMIT Attach(2)sets of Engineered Plans. <br /> ••""PROPERTY SURVEY requtred for all NEW constrvctlon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor stgn back of applicatlon,notarized <br /> If over i2S00,a Notice of Commencement ta roqulrod. (A/C upgradea over 57500) <br /> "• Agent(for the contractor)or Power of Attomey(for the owner)would be someone wfth notarized letter from owner authoriz(ng same <br /> ONER THE COUNTER PERMITTINf3 (Front of ApplicaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plof/Survey/Footage) <br /> �rivewsy�-Not over Counter If on public roadways..needs ROW <br />