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Buflding Dep rtment <br /> � ' - , 0'�G�v�l C A <br /> Date Recefved _ 2�� ' <br /> Phone.Contact f.or Pe . Ittin s►3 - �f`j 65 <br /> Owner's Name a O z�l S��P�1So 6J � Ownar Phone Numbe ��3 "7 g d�"�i 8�6 <br /> Owner's Address S 3 2$ - S rn.e_ Owner Phone Numbe <br /> Fee Simple Tltleholder Name Owner Phone Numbe <br /> Fee Simple Titleholder Addresa � <br /> JOB ADDRESS �3 �.� �n� 5`T ZePG��y�+�11S L 3 3 5'y� LOT# �� � � 6 <br /> SUBDNISION C i-F,� a-�?re?h2�k���S PARCEL ID# �ti '2��Z i -O O 1 O ' C79 60 6 -C'�/S O <br /> (OBTAINEO FROM'PR PERTY TAX NOTIGE) <br /> WORK.PROPOSED B NEW.CONSTR 8 ADD/ALT SICiN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED.USE Q. SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME STEEL Q <br /> DE3CRIPTION OF WORK � f� W r o�,7 t�N�i'S i�- �Si�. �L �Z� <br /> BUILDIN(i SIZE SQ FOOTACiE� HEI(3HT <br /> OBUILDIN(3 $ <br /> C�'(s� 3. 3 p VALUATION OF T TAL CONSTRUCTION <br /> QELECtRICAL $ AMP SERVICE Q PROG ESS ENERGY Q W.R.E.C. <br /> OPLUMBINO $ ���CeGT� <br /> QMECHANICAL $ VALUATION OF M CHANICAL.INSTALLATION ���P����� � <br /> � �aci �, n,�'�- �,f <br /> OGAS Q RO�FING Q SPECIALTY OTHER v. S� `�� �� 1't�C�� <br /> � � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZON AREA �YES � j''rf�'�� <br /> G ��� <br /> � <br /> BUILDER ' C MPA L ow-eS- l�aM�, Ge.�T�2s �.`�- <br /> SIGNATURE REGISTER D Y/ N Fe CURRE� -Y/N <br /> Address O �OK O �� 2�A��� 3�-S7y Llcens # ��oL ( sd ��� 7 <br /> ELECTRICIAN ' COMPA <br /> SIGNATURE REGISTER D Y/ N FE CURRE� Y/N <br /> Address Licens # � . <br /> PLUMBER COMPA Y <br /> 31GNATURE ; REGISTER.D Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> MECHANICAL. �, COMPA <br /> SIGNATURE REGISTER D Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> OTHER COMPA Y <br /> SICiNATURE � REGIS� o Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of En rgy Forms;R-O-W Permit for ew consUucUon, <br /> Minimum ten(10)worfdng days after submittal date. Requfre onsite,ConstrucUon Plans, tormwater Plans wl Silt Fence installed, <br /> Sanitary.Facllltles&1 dumpster;Slte Work Permlt�for subdiv slonsAarge proJects <br /> �COMMEFtC1AL'Aitacfi`(�)complsia ae��of Gulltiiry-P�a��pl�.�_-Lifa-52'sty- �c�e:-('�)set-Qf Energy-Forms.►3-O-W._P_�rmit for new construction. <br /> Minimum ten(10)working days after submittal date. Requly d onsite,ConstrucUon Plans, tortnwater Plans w/Silt Fence Insfalled,`-�-�T' <br /> Sanitary Facilities 8�1 dumpster.Site Work Permit�for all ne proJects.All commercial requi ements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> """PROPERTY SURVEY requlred for all NEW construcUon. <br /> Dlrections: <br /> Fill out appllcation completely. <br /> Ovmer&Contractor sfgn back of application,notarized <br /> If over SZ500,a Notice of Commencement is required. (A/C upgrades over E7500) <br /> `• Agent(for!he contractor)or Power of Attomey(for the owner)would be so eone with notarized letter fro owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only.) <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plo Survey/Footage) <br /> Drlveways-Not over Counter If on public roadways..needs:ROW, _ <br />