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, • e�saso-oozo City af ephyrhiiis Permit Application Fa�c-$13-784-0021 <br /> Building Departmertt <br /> Date Received ��3 ^��. — 1�� <br /> Phon Contact far Permittin <br /> Owner's Name 1 CY 1 r Owner phane Number <br /> Owner"s Address 3��3 l S `G,.• Owner Phone Number � � <br /> Fee Simpte TiNeholder Name OWner Phane Number � � <br /> Pee Simpls Tttlehotder Address <br /> JOBADDRESS �J�S�3 I�.��S Y��7'C� LOT# �U <br /> SUBDIVISIOM (','�C�(}� ��gYL2pr � PARCEI.ID# � "aS`cZi�'-Q�R�"O15af}�} " Q��a <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK AROP08E0 NEW CANS7R ADDlALT Q SlGN Q Q DEMOLISH <br /> e (NSTAl.L 8 REPAIR <br /> PROPOSED USE Q SFF2 Q COMM Q OTHER <br /> TYPE OF CONS7RUCTION Q HLOGK Q FR,4PvlE � STEEI O <br /> DESCRIPTION OF WORFC P`���n fJWuuS � I� <br /> BUILDIHG SIZE SQ FOOTAGE HEiGNT �� <br /> � —"""���HC' �',�''r��`).�f)-(JU ( VAL ATEON OF TdTAL CONSTRUCTlON <br /> �L <br /> QELEGTRICAL $�'�� AM SERVICE _ Q PROGRESS ENERGY Q W.R.E.C. <br /> ��.. I ���� <br /> QPLUMBING $ � <br /> QMECNANIt;AL $ VAt ATION OF MECHANtCAL 1NSTALtATION <br /> QGAS Q ROOFENG Q PECIAf.TY � OTHER <br /> FINISHED FLOOR ELEVATIONS � LOOD 20NE AREA QYES NO <br /> BUILDER (, �7 � COMPANY �N ��/��li-�-�� � <br /> SIGNAtURE °�— V REGISTERED Y/ N FEE CURRE� Y/N <br /> �f0�5/710�.�.'�. - <br /> Address 1'�5 L7!' L� License# ���`-�'�7 Sc�. I <br /> ELEGTRiCIAN . COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> PLUMBER � � COMPANY � <br /> SIGNATURE [ REGISTERED Y 1 N FE£CURREA Y 1 N <br /> Address License# �� <br /> IIiECHANICA4 � � COMPANY � <br /> SIGNATURE REGI87ERED Y�EE CURRE� Y/N <br /> Address License# � � <br /> OTHER � � COMPANY � � <br /> SIGNATURE REGISTERED Y/N FEE CURR@� Y/N <br /> Address License# l � <br /> i � s � � � � � � � � � � i � � � � � � t � � � i � � � � � � � � � � � � � � � � i � � � � � � � � � � � i � i � ii � � � � i � � <br /> RESIriENT3RL Attach{2}Piot Pians;{2)sets af Buiiding Pia�s; 1)set of Energy Farms;R-0-W Pertnit for new construction, <br /> Minimum ten(10)working days after submittal d te. Required onsite,Constniction Pians,Stortnwater Plans w/Siit Fence insta0ed, <br /> Sanitery Facilities 8 1 dumpster,Site Work Pe it for subdivisionsllarge projects <br /> COMMERCiAt Atfach{3}complete seSS af 8uiid'sng Pians pius a Life Satety Page:{9)set oi Ener�y Farms.ft-0-W Permfi for new construction. <br /> Minimum ten(10j woricing days after submittai d fe. Required onsite,Constnaction Pians,Stormwater Plans wt Sitt Fence instalted, <br /> Sanitery Facilities 81 dumpster.Site Work Pe it for all new projeots.All commercial requiremenls must meet compliance <br /> S1GN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required fot aII NEW c nsWction. <br /> Directions: <br /> FII out applicatla�completely. , <br /> Oimer&Con#cactor sign back af application,nofarized <br /> H over E2500,a Notice of Commencement is required. (A/ upgrades over�7500j <br /> " Agent(for the conUactor)or Power of Attomey.{for the owner) uld be someone with notarized letter trom owner authorizing same <br /> OVER THE COUHTER PERMITflNG {Fronf of Rpp(ication Oni} � <br /> Reroafs if shingles Sewers ., Service;Upgradas A/C F'nces(PIot/SurveylFootage)� , '' '�.' -. , , • <br /> � " , . , , � , ' ' , .., ic. <br /> Driveways-Not over Counter if on pubiic roadways..�eeds F2C) . , t ° �� , ' . . <br /> ,__ ,. ., ' ,, . _.. ..., „ . . ..� , ,. ..� ` ; <br /> \ <br />