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, Building Department <br /> � . �-y> :C 4 <br /> Date Rec,elved Phone.Co tact f.or Permittin `��3 2 — �'1�S' <br /> Owner's Name �—��N� GiJ�'I/�IQ Owner Phone Numba �(� "7S 2- ' S 1 �( <br /> Owner's Address �� � �—� �`'� ��e�-S T2 L Owner Phone Numbe <br /> Fee Simple Titleholder Name Owner Phone Numbe <br /> Fee Simple Titleholder Addreas � <br /> JOB ADDRESS �31 ( �-S G 11► I�2n1 S 7 R ZgPIz 2�Y�,'/%S 1=L �`3 S�2 LOT# � <br /> SUBDNISION ST���e1�i S �O l�-�1 `RCEL ID# C5� -`�6 -2� -a i � dOC'?C�O — O�� 1 � <br /> (�'� S i l V•e.R- G�!�S (OBTAINED FROM"PR PERTY TAX NOTIGE) <br />: WORK.PROPOSED NEW CONSTR DD/ALT [� SIGN Q Q DEMOLISH <br /> B INSTALL 8 �PAIR <br /> PROP08ED.USE Q SFR Q OMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q ME [_J STEEL Q <br /> DESCRIPTIONOFWORK �eP�A� � ��be2 Ne'T Si�.e. IS�+ze. �L � Zg.�i <br /> BUILDIN(i 31ZE SQ FOOTA(3E HEIGH7 <br /> QBUILDINC3 $ VALU TION OF TOTAL CONSTRUCTION <br /> `� �78.z`z <br /> QELECTRICAL $ AMP ERVICE Q PROG ESS ENERGY Q W.R.E.C. <br /> OPLUMBINO $ ,`�/ <br /> $ <br /> QMECHANICAL $ VALU TION OF MECHANICAL.INSTALLATION �1� <br /> QGAS Q ROOFING Q PECIALTY C] OTHER <br /> FINISHED FLOOR ELEVATIONS LOOD ZONE AREA QYES NO <br /> G ��� � -'l� <br /> BUILDER � COMPANY L bc,w•eS l�oM�, CeNT�2s ' �l�- <br /> SIGNATURE� REGISTERED Y/ N FE CURREA Y/N <br /> Address � QOK � ��J 2�A ��" 3t'��� Licens # ��oG � .SC� � � <br /> ELECTRICIAN ' COMPANY <br /> SIGNATURE _ REGISTERED Y/ N FE CURRE� ' Y/N <br /> Address Licens # <br /> PLUMBER ; COMPANY <br /> 31GNATURE ; REGISTERED Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> MECHANICAL COMPANY <br /> SIGNATURE � REGISTERED Y/ N FE CUftRE� Y/N <br /> Address Licens # <br /> OTHER COMPANY <br /> SIGNATURE � REGISTERED Y/ N FE CURRE� Y/N <br /> Address Lfcens # � � <br /> RESIDENTIAL Attach(2)Plot Pfans;(2)sets of Building Plans; 1)set of Energy Forms;R-O-W Permit for ew constructlon, <br /> Minimum ten(10)working days after submittal d te. Requlred onsite,ConstrucUon Plans, tormwater Plans w/Silt Fence installed, <br /> Sanitary�Facllitles 81 dumpster;Site Work Pe it;for subdivisionsllarge proJects , ,. <br />-��3h7MERC1A1� -"���,ttach(3)-camplets sets-of-Bulldiny Piansplus -��ife Safe!y-F�g�;-(')-set of Energy-�orms.�-0-Ull Psrmi4�for ne�ccn��ucUcn.--= -- <br /> Mlnimum ten(10)working days after submittal d te. Requlred onsite,ConstrucUon Plans, tormwater Plans w/Slit Fence installed, <br /> San(tary Facilitles&1 dumpster.Site Work Pe It�for all new proJects,All commercial requi ements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""'PROPERTY SURVEY requlred for all NEW nstrucUon. <br /> Directions: <br /> FIII out appllcation completely. <br /> Owner&Contractor sign back of application,notarized <br /> it over 52500,a Notice of Commencement Is requlred. (Al upgrades over 57500) " <br /> '• Agent(for the contractor)or Power of Attomey-(for-tqe owner) oul�:be someone with noterized letter fro oviine�authorizing same__,_ , ; <br /> OVER THE COUNTER PERMITTING (Front of Appli,catfon�0 ly.) `', � � � '•i' <br /> Reroofs If shingles Sewers Service Upgrades. NC:, ,: ences(Plot/Survey/Footage) , : � , . , <br /> Driveways-Not over Counter if on public roadways.:needs:RO :.. .,. " " � _:" .� <br />