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��'�t ZO+v ��h�,�{�r�1/S Bufiding Department <br /> �� YY�ONiL <br /> Date Received __ ,�;� `. �L! <br /> Phone Contact for Permittin (�4' _ �`9G� . <br /> ,.�— �' <br /> Owner's Name f � ��7 2�'p�A ����� Owner Phone Number <br /> Owner's Addresa Owner Phone Number � —1 <br /> Fee simple Titleholder Name Owner Phons Number <br /> Fee 3lmple Titleholder Address <br /> JOB ADDRE33 �g Z /,2 h� S L. 3 3 S LOT# C� <br /> SUBDIVISION IKGc' _�5 /ST . PARCEL ID# �4-�`�-O� �O •-Q i `7 0 0 -� C3f) 1 O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP03ED NEW CONSTR ADD/ALT Q SIGN [� Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM C� OTHER <br /> TYPE OF CON3TRUCTION Q BLOCK [� FRAME �� STEEL �] (--"""'----� <br /> DE3CRIPTION OF WORK ..�.��R 1 1 'h:rz.e.A IA2r+^ S ST M W � S <br /> eUILDINf3 SIZE � 8Q FOOTA(iE� HEI(iHT � <br /> BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> $ �0; e�e c�t�� <br /> .. [�ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C. <br /> y QPLUMBING $ �� � (L, <br /> �I �C/ <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> �� <br /> OGAS � ROOFING Q SPECIALTY C� OTHER <br /> FINISHED FLOOR ELEVATiONS �� FLOOD ZONE AREA QYES NO <br /> BUtLDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r� <br /> ELECTRICIAN COMPANY <br /> 31GNATURE REGISTERED Y/ N FE8 CURRE� Y/N <br /> Addresa License# �— —� <br /> PLUMBER COMPANY <br /> SIGNATURE REOISTERED Y/ N FEE CURREA Y/N <br /> Address License# � <br /> MECHANICAL COMPANY <br /> 31GNATURE REGISTEREO Y/ N fEE CUl�RE� Y/N <br /> Address License# �� <br /> UTHER COMPANY � <br /> 31GNATURE t fZp`fii.c�C'CG�rJ j�J ��j <br /> REOISTERE�F � Y/ N FEE CURRE� Y/N � <br /> Address 3 S cT STP ` 3�,iig �Q� i�5-- LlcenBe# �OC�io o�, . 1 ;�D p <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R.O-W Permit for new constructlon, <br /> Minimum ten(10)v►norking days after submittal date. Requlred onsite,Co�struct(on Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facllides 8 1 dumpster;Site Work Permit for subdivis(ons/large projects <br /> COMMERCIAL Attach(3)wmplete sets of Buflding Pians pius a Life�sfiety Page;(1)set of Energy Forms.R-Q-W Permit for new constra�cUon. <br /> Minimum te�(10)working days after submittal date. Requlred ons(te,Constructlon Plans,Stormwater Plans w/Slit Fence installed, <br /> San(tary Facflities 8�1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Ertglneered Plans. <br /> "`"PROPERTY SURVEY required for all NEW.consfrucdon. <br />)ireCtions: <br /> FIII out application completely. <br /> Owner&Contractor sign back of appNcatlon,notarfzed <br /> If over E2S00,a Notice of Commencement Is required. (A/C upgrades 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 />)VER THE COUNTER PERMiTTING (Front of Applicatlon Oniy) <br />!eroofs if shingles Sewers Service Upgrades A/C Fences{PIoUSurvey/Footage) <br /> Dr(veways-Not over Counter if on public roadways..needs ROW <br />