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<br /> Building Department �
<br /> Rate Receive�l ' � __ �
<br /> Phane Contact for Permitting ;
<br /> Owner's Name �� �-���� Owner Phone Number � '�.l$.�"'g l�Z 'I
<br /> Owner's Address s 1� "' �U� u'�� �'��5 t � �35�Z p�,�c Phane Nurnber ` �
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<br /> Fee Simpie TitlehaEder Name Clwner Phone Number� ��,
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<br /> Fee Simple 3itiehaider Address � '
<br /> �o�aunr�ss 51 t�( 1 v�' St, -� h rh►t t s , �Z �3,5�{Z- � LQT#
<br /> .L__�
<br /> sueoivis�or� �—....---.� ,Ra�tcE�::�a# �('2,4�-� Z l-Z�QI c�. - Z�bt b�C�i�O
<br /> ' � (087AINED PROM PROPERTY TAX HOTtGE)
<br /> WCiRK PR�POSED � t�4EW COi�1STR e ADDtA�T � SIGfN�� iVIOVE Q DEMOLISH
<br /> � � � '�� INSTALL REPAIR � _
<br /> PROPOSED USE , Q SFR Q COMM Q O ER �• � ' '
<br /> 7YPE OF CONSTRUCTIOt+! [�] BLOCK [� FRAME Q STEEL Q OTHER �
<br /> DESCF2IPTION OF;INORK, �� 0-�-� °"�r�'(�' i1 ` ��F' ' . "
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<br /> �..� � , �—� HEtGHT .,_.,,—..,--
<br /> BU1LDtNG SIZE _, :SQ FOOTAGE: ` � � �
<br /> (�' BUI�DING � • � --i� VALt1ATlt)iU OF TOTAL CONST`RU.CTIt3fi1 � � � �
<br /> ��lia'OQ's`iU0
<br /> Q EIEGTFl1CAL $ AMP SERV{CE �] PROGRESS ENERGY Q� W.R.E.C.
<br /> � i�
<br /> Q PLUMBING [�` � • ��r��(�'i
<br /> I },,:{� t
<br /> 7(
<br /> �'] MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION '
<br /> �,] GAS � RQOFING Q SPECIALTY Q OTHER �l����
<br /> FlNISHED FLOOFt ELEVATIONS {�'�� � FLOOD ZONE AREA [�YES QNO .
<br /> � '
<br /> ;.. .
<br /> .BUiLREi�_ __. ., ...:. ,
<br /> _ _...._.- -
<br /> OMPANY
<br /> StGNATURE ' �
<br /> - �- - - ------__.
<br /> t2EGIST�RED Y/ N . FE�cuRReNr 'Y/N ° °
<br /> Address � �icense#. � ^i�
<br /> ELECTRIGtAN GOMPANY . , - ,
<br /> SIGNATURE REGISTERED Y/ N �FEE CURRENT' Y/N
<br /> Address �icense#� '�^ (
<br /> I
<br /> FLUMBEit CQMPA[+lY � .
<br /> SICaNATURE • REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address License# �•� ��
<br /> MEGHANtCAi. COMPAPIY • �
<br /> SIGNATURE REGISTERE� Y/ N FEE CURRENT Y/N
<br /> Address ' t�tcense# � � ' 1
<br /> OTNER >COMPANY � m c¢�Y1 1 wt�n�';�.�c ` ' '. .
<br /> SIGNATURE+ REGISTHR�D N FEE CURRENT 'N
<br /> Address �lc�(�a S�-5� , r�i�!(� (r2- 33��'� '.Liceiise# !c--�./�'`Z:S''S�� �
<br /> ,,
<br /> RESIDENTIAI. Attach(2)Plot F'lans;{2)sets af Building Plans;(1)set of Energy Forms;R-O-W Permit for new construcUon,
<br /> Minimum fen('10)working days after submittai da#e. Required onsite,Canstruction Plans,5tormwater Ptans wl Sil#Fence instalied;
<br /> Sanitary Fac9Eities&1 iiumpster,S3te Wark Permit fbr'subdivisionsllarge projects �
<br /> COMMERCIAL Attach(3}sets af�BuUding Plans;(1)set of Ene�gy Forms.R-O-W.Permit for new construbtlon. ;
<br /> Minimum fen(10)working days after submitfal dafe. Required onsite,Construction Plans,Stormwater Pians.w/8ilt Fence instalfed,
<br /> Sani#ary Fac113fies&1 dumpster.Slte tNork Permit for a!1 new projects.Alt Gommerciai requirements must ineet cot»pttance' ' ` ,
<br /> SlGN FERMIT Attach(2)seks af Engineered Plans. , '
<br /> *"'PROPER7Y SURVEY requlred for alt NEW construction. . , � . '
<br /> Direotions: �
<br /> Fill out application completeiy. � �
<br /> Owner&Con#raa#or sign back o#application,no#arized
<br /> !f over$2540,a Notiae af Commencement is requ�red. (A/C upgrades over$500U)
<br /> `* Agent(for the contractor)or Power af Attomey(for the owner)would be someone with notarized leiter from owner autharizing same
<br /> 'OVER THE COUNTER PERMIITlNG (Frant of ApplicaUon Only)
<br /> Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage}
<br /> Driveways-Not over Gounter„lf on public.roadways..needs ROW - - � � . .
<br /> ,� '-����� `.ti� _ , . , z,�, ' , � � �pr. , ., ,. , ' ,, J -�� .
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