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a ir�ov-wcu v�ty vi �cNi�r�i mi.� � ai�nn r.F.F.��..u.�..�� <br /> Bu(Iding De!�artment <br /> rn a��`c..v <br /> DatN Recelved �� I � --�� phone ontact for PermftRin g t �ZLci - �q�S <br /> Owners Nama �A��Y �-�'t L.�-c:�i�. Owner Phone Number �13 ' 39 S'�-S��9 <br /> Owners Address � � t�l f�'1�. �� Owner Phone Number � <br /> Fee Simple Tftleholder Name �_ Ownsr Phone Number !� <br /> Fee Simple Titleholder Addross <br /> JOB ApDRE33 fo� i� N��'t�1► L-�k.e_ v�� Z�Pti�r�+;V S /G'L 3 3 s Y� L07# � <br /> SUBQIY,ISION 5'�e�ie�s �•��t��i Iu�A PARCEL ID�Ikk 3-26-,�/-E�i S`t� ' �ipoc� ° O�1 0 <br /> �A/E.S (OBTAINED FROM PROPERTY TAX N071�dE) <br /> WORI�_PRWP08fD New coNSTa ADD/ALT 0 SIC3N 0 [� OEMOIISH <br /> INSTALL REPAIR <br /> PROR08ED.USE Q SFR � COMM � OTHER <br /> TYPE OF CON87RUCT10N Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORiC �4CQ� / L � ^,: �nli�' S%2s.. S� t=�- � �S z 2�" <br /> BUILDIN(i SIZE � SQ FOOTA(3E� HEI(3HT <br /> QBUILDING S ���` S3 VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> [�PLUMBINC3 $ /� �� � �( � <br /> �U � <br /> QMECHANICAL S VALUATION OF MECHANICAL INSTALLATIO �,�L <br /> QGAS Q ROOFING Q SPECIALTY �] OTHER 3 <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> G C��b '�� <br /> i�C I <br /> BUILDER COMPANY 4_Okt�CS. NoMt ceN��2s �nl C- <br /> SIGNATURE RE(31STERED Y/ N �E Cuw�E� Y/N <br /> Address O �O� O Q�✓ ��A�d° �:'$7� License# ��, ( .SC7 �� <br /> ELECTRICWN COMPANY <br /> 31GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# � <br /> PLUMBER COMPANY <br /> 810NA7URE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addross License# � <br /> MECHANICAL COMPANY <br /> SIONATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucanse# � <br /> OTHER COMPANY <br /> SIONATt1RE REOISTEREp Y/ N FEE CURRE� Y/N <br /> Addresa Ltcense# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buiiding Plans;(1)set of Energy Forms;R-O-W Permit for new consUucdon, <br /> Minimum ten(10)working days after submittal date. Requfred onsfte,Constructlon Plans,Stormwater Plans w/Sitt Fence installed, <br /> Sanit�ry Fadlitles&1 dumpster;Site Work Permit for subdivislons/large proJects <br /> COMMERCIAL Attach(3)complete set�of Buildfng Plans plus a Llfe Safe!y Pa$e;(?)sst of Energy Fcrms.R-O-W Pem�lt for new�nstrucKion. <br /> Minimum ten(10)working days after submittal date. Requfred onsite,Constructlon Plans,Stortnwater Pians w/Silt Fence i�stalled, <br /> Sanitary Fadlides 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compllance <br /> 81CiN PERMIT Attach(2)seb of Engineered Plans. <br /> ""PROPERTY SURVEY requ(red for all NEW construcUon. <br /> Directlons: <br /> Fill out appfication completely. <br /> Owner&Contractor sfgn back of applicatfon,notarized <br /> If over s2S00,a Notice oi Commencement is roquired. (AIC upgrades over=TS00) <br /> •` Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner autho�izing same <br /> OVER THE COUNTER PERMITTIN(i (Front of ApplicaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />