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- Build�ng Departrrent <br /> Y'� N7�C <br /> Date Received Z-�-� 1 phone Coritact for Permittin �'� 3 2 - �1`9-6 S' <br /> Owner's Name � !� �, � Owner Phone Numbe �3 -�"�?`� = `31� `� <br /> Uwner's Address SArv�2._ Owner Phone Numbe <br /> Fee Simple Titleholder Name �� Owner Phone Numbe �— <br /> I <br /> Fee Simple Titleholder Addresa ' <br /> JOB ADDRESS b��� f �� S"i Z2P�►2I h:�15 �L 3 3 S"4�� LOT# �� <br /> SUBDIVISION �P/a�Llc t+�7) PARCE ID# O`�.'2�'�'Lt` d�g - 11F�a�� `dS(00 <br /> (OBTAINED FROM P PERTY TAX NOTIGE) <br /> WORK.PROPOSED ,NEW CONS7R ADD/AL Q SIGN Q Q DEMOLISH <br /> e IN3TALL 8 REPAI <br /> PROPOSED.USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION �] BLOCK Q FRAME C] STEEL [� <br /> DESCRIPTION OF WORK ��Y 1AC2 2 .0 o 0 2 N e'�'S S',?� S i TL �O y � FL�Z.�j'G9,� <br /> BUILDING SIZE SQ FOOTA(iE� HEIGHT <br /> �BUILDINO $ 23��,c VALUATION OF TOTAL CONSTRUCTION <br /> 0 <br /> QELECTRICAL $ AMP SERVI �E Q PROG ESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ �[p I a,� `� <br /> .0 � �-�- `� `'1 <br /> QMECHANICAL $ VALUATION aF MECHANICAL.INSTALLATION a� ��ti <br /> �F \ <br /> [�GAS Q ROOFING Q SPECIA TY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ONE AREA QYES NO <br /> i G (��'� �-�—'"Z� <br /> . l� <br /> BUILDER , ,n J' CO PANY �ow-eS_, ldoMe, CeN'��2s � L�'G <br /> SIGNATURE y � � (�(X� REG STERED Y/ N FE CURREA Y I N <br /> Address o C3o� ' � °�✓ /L�A���' 3�-��y Licens # C��G f S d ��l 7 <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REG STERED Y/ N FE CURRE� Y/N <br /> Address Llcens # <br /> PLUMBER COMPANY <br /> SIGNATURE REG,STERED Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> MECHANICAL , CO PANY <br /> SIGNATURE REG STERED Y/ N FE CUFtRE� Y/N , <br /> Address Licens # I <br /> OTHER � CO PANY � <br /> SIGNATURE REG STERED Y/ N � cuRrten 1'/N <br /> Address 1 Llcens # <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1�)set f Energy Forms;R-O-W Permtt for ew construcUon, <br /> Minimum ten(10)workfng days after submittal date. Required onsite,Constructlon Plans, tormwater Plans w/Silt Fence installed, <br /> Sanitary.FaGlfUes&1 dumpster;Site Work Permit for s�bdivislons/large proJects <br /> COMMERCIAL Attacn(3)complete sets of Bu.ld�ng Plans plus a Life S fety Page;(1)set of Energy FoRns.R-O-W Pertnit for new construction. <br /> - -____, _ _ -:_ Mlnlmum ten(10)working days after submittal da;e.-R�uired c�nsite,ConsGuctfon Plans, tormvirater Plans w/Silt Fence installed, <br /> �— ��� � Sanitary Fa'cilit�es 8�1 dumpste�.-51ta'1fJaricPerrri,�fors���aw pr.;;a1!s:A!I comme!cial requi emerts must meet,compliance - - _ <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. � ~ � ~_ - --- -- --� <br /> •'"'PROPERTY SURVEY required for all NEW construcGon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (AIC upgr�des over 57500) <br /> � " Agent(for the contractor)or Power of Attomey(for the owner)would b someone with notarized letter fro ovmer suthorizing same _ <br /> OVER THE COUNTER PERMITTING (Front of Appllcatfon Only.) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences �PIoUSurvey/Footage) � <br /> �. f <br /> Drlveways-Not over Counter if orr public roadways..needs'ROW� . � <br />