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IBuildingDe artment �P�R,� h �1S <br /> 'Y1- - d C.!a <br /> Date Recelved — �`� 2 � <br /> Phone,Contact i�r Pe ittln - a � <br /> Owher's Name J �A,sJ �. F}?( Owner Phone Numbe �l� - �o`� S-�� l�2 <br /> Owner'sAddress �gO,sO �,�1�,, �� �-�,�tlS �L OwnerPhoneNumbe . � <br /> 33s�r2 <br /> Fee Slmple Titleholder Name Owner Phone Numbe <br /> Fee Stmple Tttleholder Addreas ' <br /> JOB ADDRESS � 6 O� ��� (-�t�� ZePG►2.y ��i�S F(, '�"?�S 2 LOT# �� <br /> SUBDNISION �2Y��!IS ���.��n� PARCEL ID# Z'2�O`�� '��3 '0C� �O� " 0 3�O <br /> � (OBTAINEO FROM PR PERTY TAX NOTICE) <br /> WORK.PROP03ED e NEW CONSTR B ADD/ALT SIGN Q Q DEMOLISH <br /> IN$TALL RE�PAIR� <br /> PROPOSED.USE Q, SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME STEEL Q <br /> DESCRIPTION OF WORK I r I �G9 2 11 S r'?� ss <br /> tL �9oy,6 <br /> BUILDIN(i SIZE SQ FOOTA(3E� HEI(3HT FL_} � t S 2, 3 <br /> , <br /> Q/'3�UILUINC3 $ 2I 3 ,Sg VALUATION OF T AL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROG ESS ENERGY Q W.R.E.C. <br /> QPLUMBINO $ . � �3 <br /> � �� <br /> [�MECHANICAL $ VALUATION OF M CHANICAL INSTALLATION <br /> [�GAS Q ROOFING Q SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE REA QYES NO <br /> G �-,�;d 1�„"Z= <br /> BUILDER `' �/ln y" � ' COMPAN �(.ow-eS _l-�oMe, CeNT�2s �a�l c. <br /> SIGNATURE �r �`�� � REGISTERE Y/ N FE CURRE� Y/N <br /> Address p Qp� � � q� 2�A��`� �L�7� Licens # ��oL Sd � � <br /> ELECTRICIAN ' COMPAN <br /> SIGNATURE REGISTERE Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> PLUMBER COMPAN <br /> $IGNATURE ; REGISTERE Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> MECHANICAL- , COMPA <br /> SIGNATURE � Re�isreRe Y/ N FE CURRE� Y/N <br /> Address Licens # � <br /> OTHER COMPAN <br /> 31GNATURE � REGISTERE Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bulldfng Plans;(1)set of Ener y Forms;R-O-W Permit for ew construcUon, <br /> Minimutn ten(10)worfcing days after submittal date. Requlred nsite,Constructlon Pians, tormwater Plans w/Silt Fence Installed, <br /> Sanitary�FaGllties&1 dumpster;Site Work Permit,for subdivlsi nsAarge proJects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety P ge;(1)set of Energy Forms.R-O-W Permit tor new constructlon. <br /> _- � . ,__Min(mum ten(_10)wc+rking_days after submlttal date. Required nsite,ConstrucUon Plans, tormwater Plans w/Silt Fence Installed, <br /> Sanitary FacilNles&1 dumpster.Site Work Pemift�fo�all naw p oJects,All commerclaE requi ements must meet-compllance - -__ _ _ _� <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ••'•PROPERTY SURVEY required for all NEW construcUon. <br /> Dfrections: <br />� FIII out appllcation completely. <br /> Owner&Contractor slgn back of appl(cation,notarized <br /> If over 52500,a Notice of Commencement is requlred. (AIC upgrades o er E7500) <br /> '• Agent(for the contractor)or Power of Attomey(for the owner)would be some ne with notarized letter fro owner authorizing same <br /> OVER THE COUNTER PERMITTING (Frorit of ApplicaUon-Only) �.: <br /> Reroofs If shingles Sewers , Service.Upgrad'es' A/C ;Fences;(PIoUS rvey/Footage) <br /> Drlveways-Not over Counter if on:public roadways:.needs ROW ;, <br />