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,..,,,,,,�.. ..��y .,,� c..crN��yi�inio � �������,.rr��..�.,.�..�, <br /> Building Dspartment <br /> !'+'►G N i�c.� <br /> Date Recel ed ��j� Phone Contact for Permtttin I 3 2��'l - �`���S <br /> Dwner'a N me� ( ! �+�At.l Ownar Phone Number �i3--�3 Q ` 3 �`� 3 <br /> Owne�'s A dress C SAr� � Ownor Phone Number <br /> Fee Simpl Titleholder Name OwnAr Phone Number � � <br /> Fee Simpl Titleholder Addreaa J <br /> JOB ADD ESS �3 �� "�Ro N �c�caG� P C. ZeP��`/h+1 I S FC. 3��`1� LOT# �� <br /> SUBDIVI31 N D2i�Tw�cd 0� ��'�11'I PARCELID# b�-`�`��OZIA 'Q���O -- �O(O ] <br /> C e r•�,7� (OBTAINED FROM PROPERTY TAX NOTIGE) <br /> WORKPR P03ED e NEW CONSTR 8 ADD/ALT [_� SIGN [� Q DEMOUSH <br /> INSTALL REPAIR <br /> PROPOSE USE [�] SFR [_] COMM � OTHER <br /> TYPE OF ON3TRUCTtON Q BLOCK Q FRAME C� STEEL Q <br /> DESCRIP ON OF WORK l t����Gl� �W� A1n�1`�.J uN i�_S��t-2. / s�Z-� �L j f�Z d ] <br /> BUlLDIN(3 SIZE [ SQ F007A�3EI� HEIGHT �- <br /> Q UILDIN(� S ��` �,� VALUATION OF TOTAI CONSTRUCTION <br /> b <br /> Q LECTRICAL � AMP SERVICE [� PROGRESS ENERGY Q W.R.E.C, <br /> Q LUMBIN(3 $ <br /> ECHANICAL $ VALUATION OF MECHANICAL INSTALLATION /�/�6 <br /> 0 � <br /> Q AS Q ROOFING Q SPECIALTY �] OTHER <br /> FINISHED LOOR I;LEVATIONS FLOOD ZONE AREA QYES NO <br /> � C�R'� �'�"�"ii <br /> Iv <br /> BUILDER pANY L O�-C S NoroC C BaT�2s oJ C- <br /> SIGNATU E ���� REGISTERED Y/ N FEE CURRE� Y/N <br /> Addr ss ['�"� ��`� �� �/1 '�'� 3 Q��A�"�ci 3�-�7J�' Llcense# �..�o�. � .5C7 �� <br /> ELECTRI IAN � COMPANY <br /> SIGNATU E [ REGISTERED Y/ N FEE CURRE� Y/N <br /> Addr ss [ License# <br /> PLUMBE COMPANY <br /> 310NATU E REGISTERED Y/ N FEE CURRE� Y/N <br /> Addr sa [ License# � <br /> MECHANI AL � COMPANY <br /> SIGNATU E REGISTERED Y/ N FEE CURREh Y I N <br /> Add ss l � License# <br /> OTHER COMPANY � <br /> 31(3NATU E , REGISTERED Y I N FEE CURRE� Y/N <br /> Addr ss � � License# � � <br /> RESIDEN IAL Attach(2)Plot Plans;(2)sets of Building Plann;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Requfred onsite,ConsUuctlon Pians,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadl(Ues&1 dumpster;Site V1�ork Permit for subdivisions/large projects <br /> COMMER IA� Attach(3)complete sets of Bu!!ding r'lan�al;:s a life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permft for ali new proJects.All commerclai requirements must meet compllance <br /> SIGN PE MIT Attach(2)sets of Engineered Plans. <br /> "'""PROPERTY SURVEY requlred for all NEW consVucdon. <br /> Directfon : <br /> Ffli o t application completely. <br /> Own r&Contractor sign back of appifcatfon,notarized <br /> If ov r 52500,a Not(ce of Commencement Is requlred. (�UC upgradea over 57500) <br /> •' Agen (for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER TH COUNTER PERMITTIN(3 (Front of Appllcatlon Unly) <br /> Reroofs If hingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driv ys-Not over Counter If on public roadways..needs ROW <br />