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� Buildfng partment <br /> o.J G� <br /> Date`�ecelved � Phone,.Contact.f.or P rmittin �S I� '2 - �'�(p� <br /> Owner's Name _^�iq i( i /����'L Owner Phone Numb r ���� -- ��`���7 � <br /> I �Owner's Address Owner Phone Numb'r <br /> Fee Simple Titleholder Name Owner Phone Numb r � � <br /> Fee Simple Titleholder Address ' <br /> JOB ADDRESS �C��q u`�V /h �� Z�h R � 1`j�S I`-L.�� � � LOT# 1 3 <br /> SUBDIVISION Lit`( �� �P��y�►'l� PARCELID 1 � -�-2, -OD i� �-�-1 �°0� ~ C� t 3 ( <br /> � (OBTAINEO FROM P OPERTY TAX NOTIGE) <br /> WORK PROP.,OSED NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH <br /> B , INSTALL 8 REPAIR <br /> PROPOSED.USE [�.; SFR Q COMM � OTWER <br /> IYPE OF CONSTRUCTION Q� BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �^,�i��� { �t O� J� r C�t1� ��- ��N1r Z- �.�1G� W i�� I C,�l h'�(� � "I�� <br /> � �2.e/�^o r�� �ac i i'Ti�•7� <br /> BUILDING SIZE I SQ FOOTACiE , HEIGHT + Na.,L �w�y <br /> � <br /> QBUILDINO $ � �� � VALUATION OF OTAL CONS'TRUCTION <br /> QELECTRICAL $ ' AMP SERVICE Q PROG ESS ENERGY Q W.R,E.G. <br /> i <br /> QPLUMBING $ � ���2S <br /> i <br /> QMECHANICAL $ VALUATION OF ECHANICAL.INSTALLATION <br /> QGAS Q ROOFING Q � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZON AREA QYES NO <br /> � � G ��� <br /> BUILDER � COMPA Y L bc,w-eS L�OM�, CQN�'e2s ��+./�., <br /> SIGNATURE � � REGISTE ED Y./ N FE CURRE� Y 1 N <br /> Address O �O� �� ��J 2�A��� 3i"��� Licens # G6G f Sc���I 7 <br /> � <br /> ELECTRICIAN COMPA <br /> SIGNATURE REGISTE ED Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> PLUMBER � COMPA Y <br /> SIGNATURE REGISTE D Y/ N FE CURRE� Y/N <br /> Address � License# � � <br /> MECHANICAL, COMPA i � <br /> 51GNATURE REGISTE D Y/ N FE CURRE� Y/N ' , <br /> Address � j License# � <br /> i <br /> DTHER COMPA Y <br /> 51GNATURE � Re�isTE o Y/ N FE CURRE� Y/N : <br /> i �Address � License# �� <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)set of En rgy Forms;R.�O-W Permit for ew construcdon, <br /> Minimum ten(10)working days after submittal date. Require onsite,ConstrucUon,Plans,.S ormwater Plans w/Silt Fence installed, <br />� - -- -- --Sani;ary��zc�lltEes 81-dumpster;-Sl�e Work t?ermit for subdivl.IonsAarge p�dJects � _ <br /> ;,OMMERCIAL Attach(3)complete sets of Bufiding Plans plus a Life Safety age;{1)sef o�Energy Forms. =O=Yv Permit fisr new cons�uciion.�`"-- - <br /> Minimum ten(10)wortcing days after submittal date. Require onsite,Construction Plans,S ormwater Plans w/Silt Fence-installed, <br /> Sanitary Facillties 8�1 dumpster.Site Work Permit for all new projects,All commercial requir ments must meet compllance <br /> 31GN PERMIT Attach(2)sets of Engineered Plans. � <br /> �RR�PROPERTY SURVEY required for all NEW construcUon.. <br /> )irections: <br /> FIII out application completely. _ <br /> Owner&Contractor sign back of application,notarized <br /> If over E2500,a Notice of Commencement is requlred. {A/C upgrades ver 5T500) <br /> ` Agent(for the contractor)or Power of Attomey(for the;owner)would be so one with notarized letter from owner authorizing same <br /> .. . � . . x , , _. . .. . <br /> )VER THE COUNTER PERMITTIfVG (Front of Appllcation:Only) , . , <br /> teroofs if shfngles Sewers `, Servfce Upgrad'es A/C . Fences(Plot/ urvey/Footage) � - , 7-.;. ' ' <br /> , . , . _ , , , <br /> . � . _ , , •,. � - <br /> Driveways-Not over Caunter if on_pubflc.roadways..needs RO.W.- • ° ` ` ' <br />