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o►a-�ou-uu�u c;ity ot�eph�rmi��s �ermit Application Fax-8S3-780-0021 <br /> Buflding Department <br /> ate Received Phone Contaet fo�Permittin ? � __ ,S(o'�`��., <br /> Owner's Name v 9'rC /!� Y£ '�v,�,�''� Owner Phone Number <br /> Owner's Addresa �i�7�� �(. /,S�,v� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � —� <br /> Fee Simple Tkleholder Address <br /> JOB ADDRESS LOT� C� <br /> SUBDIVISION PARCEL IDN ��- �"�/—O b r(� —c;!e��'�'O a � v�.�f� <br /> (OBTAINED F�PROPERTY TAX�NOTICE)DEMOLISH <br /> WORK PROP03ED � NEW CONSTR 8 ADD/ALT � SIGN <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM [� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �� STEEL Q <br /> DESCRIPTION OF WORK p r C� / G//V � �� f v ' <br /> BUILDIN(3 SIZE � C.� T Sq FOOTAGE�� HEIGHT � � <br /> �BUILDING 3 VALUATION OF TOTAL CONSTRUCTION <br /> /�S�D o <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING a <br /> QMECHANICAL a VALUATION OF MECHANICAL iNSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � j J� � /� �� ` COMPANY /�S C v CL�I�Cts G'J /,.e'C <br /> SIGNATURE �.,� L,�P � '� REGISTERED N FEE CURRE� N <br /> Address Ucense# � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Lfcense# —� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> 31GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Addreas License# �— <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construcGon, <br /> Minimum ten(10)working days aRer submfttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadfltles d�1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMMERCtAL Attach(3)complete sets of Bullding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new conshuction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Conshuctfon Plans,Stortnwater Plans w/Silt Fence Installed, <br /> Sanitary Faciflties b 1 dumpster.Sita Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY requir�ed for all NEW consUuction. <br /> Directtona: <br /> Fill out applicaHon completely. <br /> Owner 8 Contractor sign badc of applicatlon,notarized <br /> If over S2S00,a Notfce of Commencement is required. (AIC upgradea over 57500) <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 Appticatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage) <br /> ,,p�iveways-Not over Counter if on pubiic roadways..needs ROW <br />