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,.,..-,.,,...,.�„ �.��y u��.oNiiyiim�a rci�iu�i��uuc.a�wn �a..-.,�.,-�uo-..�<�
<br /> 9uilding Departrnent
<br /> Date Received Pl�one Contaq for Permittin " ';j -'
<br /> �
<br /> _r ,
<br /> C s Name ��� r 'i}i"r:' - -, �:.� _. Jwner°hone Number - - "'J 1L.-
<br /> Owner'sAddress - -:�tii`: `_�oZ:::ufrr _>• . `� .•o•i:�t`:;'_' OwnerPhaneNumber
<br /> Fee Simpie'T;Ueholder Yame Ownar Phone Tlumber _--�
<br /> ree Simpfe Titlenolde;Addte^.s
<br /> /�7 r� �
<br /> .�oa.qnoK�ss ���;!"�<� YZ:t�`;' -`:�,r.:, �•'n _:',�., _ �o?a
<br /> SUBDIVISION � � PAftCEL IDA "i: ' � ' "� - ' J ' ' ..�L':".�
<br /> (OBTIUNFA iROM PROPERTY T117C NO'i1CF�
<br /> ?MORK PROPOSED e NEW CONSfR� ADO/ALT � SIGN Q Q DEMOLISH
<br /> INSTALL REP/UR
<br /> PROPOSED USE Q SFR Q COMM � OTHER
<br /> 7YPE OF CONSTRUCTIOM Q BLOCK Q FRAME � STEEL Q
<br /> DESCRIPTION OF WORK !"VCrJV�V.I'T� �=�i S�;.4� i i%��i 1 G i i�4f� > /N�T�o �,G1,V /��`i .;.l0 Y C,/��•
<br /> BUtLDING S1ZE ,_��� S4 FOOTAGE{� HEIGHT �.ec!({c
<br /> [�BUILOING S � � — VALUATION OF TOTAL CONSTRUCTION
<br /> DEIECTRICAL S AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
<br /> �PLUMBING $ \�) j;t t'� n�a'"S
<br /> r'�, �.Q-�.�
<br /> OMECHANICAL $ VALUATION OP MECHANICAL INSTA�lAT10N i� n.ti'ti�`���'� �� �
<br /> ,,;;� �,�, �,�1 j-�E��!
<br /> ;�� �
<br /> QGAS Q ROOFING Q SPECIALTY � OTNER ��' �
<br /> ,� jc��"1�-,
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZOIVE AREA QYES NO
<br /> , -:
<br /> BUILDER ��1LS/tj�/L�n.--_� '. COMPANY ��I f(,i.,!/kM S ��t 1�1b�(Y T 1LP/` i�{Y�
<br /> SIGNATURE aEGisrEREO/,Y Y/ N �E wru�n Y/N
<br /> Address 5 G u�arT F?-vo .— ?�/� License# ('�G' �J�y�,3�
<br /> ��n �a�ga�k. � ,. �'�- � gT�
<br /> I,ECTRICIAN � COMA0.NY j`�1�Wy�l L�ZCGTXI ��n�
<br /> SiGNAT.URE r�c�stES�o v/ N �cunn�r. Y/N ,ti C_
<br /> �
<br /> Address �ONRoE� L �tt.3� ,',�nlC �3S License# ,�G"C�Y).,2�n l.C� I
<br /> �Lk
<br /> Jp};^� �� �COMPATdY /�'tUt�,"RN �LlJl�7f3lNG h�
<br /> 3�!t/►�lRE '-- " A�l !�� r�oisrv�o Y 1 N �cuween Y!N
<br /> y7 �. 7t!'1�5 5
<br /> Address . /LC7l T l�V:`i�,r.�, ��C.. 3yy$�� Llcense# �
<br /> �;'' �
<br /> �'�;��MECHANICAL : ��'� '1 � - � COMPANY 'R�TfC� � G
<br /> -:i�. `, �� ,- 1 1.��l:lll�:_,�. � ��� j':.
<br /> .:•i° �TURE - . Y rtEGISTERED Y/ N FEE CuRRED Y/N
<br /> Address � i-,,a,(•'�c �L ,3 �(O License# [�/� GS�7�.2Ln �
<br /> OTHER COMPAPIY
<br /> SIGNATURE r�o�s7ertEO Y/ N �cunnen Y/N
<br /> AddtlSS Ucense#
<br /> RE3tOENTIAL Altacti{2)Plot P�ens;(Zj sets of Bulldi�Plans;('I)set of Energy Farms;R-O-W Pertnit(w new oonstrucNo�.
<br /> Minimum ten(10)workfig days aiter submitfal tlate. Req�iiretl onsite,Crnstructlon P1ans,Stormurater Plans w/Silt Fence instaifed,
<br /> SanlWry Fadlitles 6 1 dumpster;Sile Wark Permlt far s�divlsionsllerge pcoJeds
<br /> COMMERClAI Attach(3)cnmplele sets of BNI��g Plans plus a Llfe Satety Page;(7)set of Energy Fortns.R-O-W Permit for new wnshuctlon.
<br /> Minimum ten(10)world�days afler submtttal date. Required onslte,ConstrucNon Plans.Stormwatw Pians wl Siit Fence instal�ed.
<br /> SaMlary Facilities 81 dumpstar.Site Work Partnil tor ali new projects.Ail cammercial requirements must meet compllance
<br /> SIGN PERMIT Atfach(2)sets of En9lneared Plans.
<br /> ""'PROPERTY SURVEY requlred for aN NEW co�sWCtion.
<br /> . tions:
<br /> Fill out applicatlon c:ompletely.
<br /> Ovmer&ConUactor stgn badc of applicallon,nolartzed
<br /> !!over 52500,a Notice of Commencemeot!s reqW red. (AJC uygredas over 8750D)
<br /> " Agent(for the contractor)or Power of Atlorney(for the owner)would be wmeone wlfh nolarized leltar from owner aulho�izing same
<br /> OYER THE COUMfiER PERNIITTIVG (Front of Application Only)
<br /> Reroofs il shingles Sewers Service Upgrades A1C Fences(PIoVSurve;�/FOOtage)
<br /> Driveways-Not over Counler if on public roadways..needs ROW
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