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Jun. 05.2014 06:32 AM PAGE. 4 <br /> G Buitding DepaAment <br /> Date Received � �� Ahane Contaet!or permintn � �� — (Z <br /> Qwner's Hame � /�1� Owner Phona Number �� '",0 �� �� <br /> Owner's Address � ' Owner Phone Number <br /> Fee Simpte 7illeholder Name ^� Owner Phone Number <br /> Fee Simple Tflleholdet Address <br /> JOB ApDRE55 Z% i.OT# 1 I <br /> L�._! <br /> SUBDIVISION � PARCfL IDfd <br /> (OBTAINEOFIiOMP OPERTYTA%HOTICB� <br /> WORKPROPOSED e NEWCONSTRe ADO/ALT Q SIGN Q OEMOLiSH <br /> INSTALL REPAIR <br /> PROPOSED USE O SFR Q COMM Q 07HER <br /> 7YPE OFCONS7RUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRfPTIQN OF WORK LG(/ �Q/l � <br /> ! <br /> BUII,DING SiZE �� SQ FOOTAGE IL�� FIEIGHT <br /> QBUILOING �S DO/1 VA�UAFION OF TOTAL CONSTRUC710N <br /> l/ <br /> [�ELECTRICAI b AMP SBRVICE �] PROGRESS ENERGY Q W,R.E.C. <br /> OPLUMBING § <br /> [�MECHANlCAL S VALUqTION OF MECHANICAI.lNSTAI.I.ATI )�._ j� ?�V <br /> xi" { <br /> QGAS Q RDOFING Q SPECIALTY Q OTHEit , <br /> FINISHEO FLOOR EIEVATIONS FtOOD ZONE AREA QYES NO <br /> BUII.pER COMPANY <br /> SIGliA7URE REGiSTEfiEO Y/N FEECUartEt. Y/N <br /> Address . License# <br /> � �I t n EiECTRICfAN �,p COMPANY ��(,/'(�� ��{L P�C� <br /> l StGNATURE r�clsreReo Y!N r�E cuaad. Y f M_ <br /> ���v,[� � `� Address � Qll� ?j ,Z. LiwnsefF �f�-����f+ 6 <br /> V`�,y. <br /> PLUMBER COMPANY <br /> SIGNA7IJRE REGISTEREO - Y/ N FEEqtqRP1, Y/N <br /> Address License� �—�� <br /> MECHAPlICAL � CDMPANY � <br /> SIGNATURE � REGISTEFEO��� Y/N FEE CllitREh Y I N <br /> Address i ' License# <br /> OTHER � COMPpNY �������IoC/� L1�S�� <br /> SIGNATURE RECisreaen � Y! N �ECUrir�n Y/N <br /> Address Lieense f�� <br /> RESI�EN7IAL At�aeh(2)Plol Alans:(2)sels ot Bultding Plans;(1)sel oi E�ergy Forms:R-O-W pettnll for new consUuction. <br /> Minimum ten�SO)working days after submiltal da�e. Required onsite,CansVuction Plans,Stomrwater Plans wi Silt Fence InsMalled, <br /> Sanitary Facilfties d 1 dumpster;Sfte Work Permit for subdivi:ionsliarge praJects <br /> GOMMERCIA4 Attach(3)camp{ete sels of 9uilding plans ptus a LiEe Sa(ery Page;(ty set of Energy Forms.R O-W Permit for new eonsWcltoa, <br /> kfinimum ten(19)wrorkfng days afte�submitlal date. Required ansite,Canstruc6on Plans,Stormwater Pfans w!Siit Fence instailed, <br /> Sanilary FaciliGes 6 t dumpster.Sile Work Permtt far all new projacts.AIt commercial re�uirements must meet compliance <br /> SIGN PERMIT Atlach(2)sets nf Engineered Plans. <br /> ""PROPERTY SURVEY requtred for all NEW constructlon. <br /> Directlons: <br /> F(II out appliration completely. <br /> Qwnu&Contracror sign back of applicaGan,natarized <br /> If over;2500,a NoUce of Commeneeme�t is required, (A!C upg2des over 57500� <br /> " Agenl(1or the contractor)or Power of Aflomey(for Iha owner)would be someona wiltt nofar¢ed lefter from avmer auU�orizing same <br /> OVER THE COUNTER PERMTTTIN6 (Frontof Application Only) <br /> Rerao(s if sMngles Sewers Service Upgrades A/G Fences{ploVSurvey/Footage) <br /> Or(veways•Not over Cotmter if on puMie roadways,.needs ROW <br />