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Buiiding Q partment <br /> ` v+�o�-:�c.w <br /> Date Recelved � <br /> Phone,Contact Tor P rmittin �S i 3 2 R _ '`�t� fo 5" <br /> Owner's Name t �"�� � ge,� Owner Phone Numb r �l 3 -7 $2 -�,�'7 � <br /> � <br /> Owne�'s Address �5-�Sry � �'T� ST Owner Phone Numb r <br /> � <br /> Fee Simple Titleholder Name Owner Phone Numb r . <br /> Fee Simple Titleholder Address <br /> � <br /> JOB ADDRESS .�lsy , f � ST �Pti RY h i l l S r-� 3 3 sy 2 LOT# C� <br /> � <br /> SUBDIYISION C�� (g� Z2QAJLYj,,'l)S PARCEL ID# � 1 -2�-�1 - �Q I 0 ���t9 O� °d0�� <br /> � (OBTAINEO:FROM P OPERTY TAX NOTIGE) <br /> WORK.PROPOSED I NEW CONSTR. ADD/ALT SI(3N Q Q DEMOLISH <br /> B' INSTALL 8 REPAIR <br />, PROPOSED USE [�.� SFR Q COMM OTWER <br /> i 7YPE OF CON3TRUCTION Q � BLOCK Q FRAME STEEL Q <br /> DESCRIPTION OF WORK ��(-) C J� W t�NG O r�J�tst �`1"S si� �Si F L <br /> � <br /> BUILDING 312E I � Sq FOOTA(iE� HEIGHT �L � � 3?�. I <br /> UILDINO $ Z�� � �� VALUATION OF T TAL CONSTRUCTION <br /> � <br /> QELECTRICAL $ ; AMP SERVICE Q PROG ESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ �� <br /> i � <br /> � �i`' <br /> QMECHANICAL $ VALUATION OF M CHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE REA QYES NO <br /> � � G ��� � <br /> BUILDER � COMPAN L Oc,w-�S I��MC, CeN7�2s ,�!•�. <br /> SIGNATURE REGISTERE Y/ N FE CURRE� Y/N <br /> Address O QO u � ��J 2��F1��cy 3�-$7�' Licens # ��oG ( .S(� �i t'�-� 7 <br /> ELECTRICIAN ' COMPAN <br /> SIGNATURE � REGISTERE Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> PLUMBER COMPAN <br /> SIGNATURE ! REGISTERE Y/ N FE CURRE� Y/N <br /> Address , Ucense# � � <br /> MECHANICAL , COMPAN I <br /> 51GNATURE REGISTERED Y/ N FE CURRE� Y/N ; <br /> I <br /> Address ' I Lfcense# <br /> DTHER COMPANY <br /> SIGNA7URE REGISTERED Y/ N FE CURRE� Y/N <br /> Address � � License# ' <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energ Fonns;R�O-W Permlt for ew consUuctlon, • <br /> Minimum ten(10)working days after submittal date. Requlred o site,Cons�ruction Plans,S ormwater Plans w/Silt Fence installed, <br /> Sanitary�Facllities 81 dumpster;Site Work Permit for subdivlsio s/large prdJects _ __ ___, i <br /> �OMMERCIAL Attach(3)complete sets of 9uildint�P_l�ns_plus a Life Safafy_Pa e;(1)��et ot�rtergy Foms. -O-1N-�'a`rmit-��new wns6uctlon. <br />- � -° ---_�-"�tvlinimum ten�10j working days aNer aubmittal date. Required o site,Constructlon 1'lans,S ormwater Plans w/Silt Fence installed, <br /> Sanitary Facflities&1 dumpster.Site Work Permit for all new pr Jects.All cbmmercial requir ments must meet compllance <br /> i1GN PERMIT Attach(2)sets of Engineered Plans. , � <br /> """"PROPERTY SURVEY requlred for all NEW consUucUon. <br /> i <br /> Jfrectlons: � <br /> FIII out appNcatfon completely. _ <br /> Owner&Contractor sign back of applicallon,notarized <br /> If over SZ500,a Notice of Commencement is�requlred._ (AIC,upgrades ov r b7500) ; <br /> ` Agent(for the conUactor)or Pouier of Attomey(for the owner)would be someo e with notarized letter from owner authorizing same <br /> )VER THE COUNTER PERMIITING , (Front of Application Only) = . ° <br /> teroofs if shingles Sewers ;�:Servic.e_UPgr,ades A/C, .: Fences(Plot/Su ey/Footage) <br /> : �� - .. ..:., .,._, <br /> Driveways-Not over Counter if on publlc roadways..needs ROW <br />