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� Bullding Department <br /> `Gi� <br /> Date Received : � ��'L�� phone Co tact for Permittin �6� 3 2 �l - �'�fo� , <br /> Owner's Name ��g-1- S��s�(e B i�e � Owner Phone Numbe �t3 -�l'79 -d�? f S <br /> � • <br /> Owner's Address 3 `j�C7� q'T� R✓-e- Owner Phone Numbe <br /> Fee Simple Titleholder Name Owner Phone Numbe � <br /> Fee Simple Titleholder Addreas <br /> JOB ADDRESS 3� J�d� �1'�'+ A'� Z�Pti� �"��5 (-C.. 3 3 S�/Z LOT# Z-� <br /> SUBDIVI310N ��nlS-e-T �S n P 'RCEL ID# �2'26�2l-03 c�50 aOp�� " �2-�O <br /> (OBTAINED FROM PR PERTY TAX NOTIGE) <br /> I� WORK.PROPOSED B NEW CONSTR 8 D/ALT � SIGN Q Q DEMOUSH <br /> INSTALL �PAIR <br /> PROPOSED.USE Q SFR Q OMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q F ME �� STEEL Q I <br /> DESCRIPTIONOFWORK �����e. � �viN� cU u�v:tS 5'�Z'E-/SiZ.t° � / �Sr12 � / �SLg <br /> BUILDIN(i SIZE SQ FOOTA(iE HEIGHT <br /> �BUILDIN(3 $ �,��� y� VALU TION OF TOTAL CONSTRUCTION <br /> QELECtRICAL $ AMP ERVICE Q PROG ESS ENERGY Q W.R.E.C. I <br /> QPLUMBING $ /^ � G� � � <br /> �]MECHANICAL $ VALU TION.OF MECHANICAL INSTALLATION � � la,�✓ <br /> � 2 � I <br /> OGAS [� ROOFING Q PECIALTY [� OTHER � ��� �I�� il <br /> I FINISHED FLOOR ELEVATIONS LOOD ZONE AREA QYES NO � I <br /> 2P G ��d � ' <br /> S <br /> BUILDER OMPANY L ow-eS:l�o.�z, Ce���2s � n/c- <br /> SIGNATURE � REGISTERED Y/ N FE CURRE� Y/N <br />� Address O �O K � ��J 2�A ��' 3:'$7� Ucens # ��oG � .S� �i �� <br /> ELECTRICIAN ' COMPANY <br />� SIGNATURE REGISTERED Y/ N FE CURREA Y/N <br /> Address , Licens # <br /> PLUMBER . COMPANY <br /> 31GNATURE ; REGI8TERED Y/ N FE CURREA Y/N <br /> Address Licens # <br /> MECHANICAL , COMPANY <br /> SIGNATURE REGISTERED Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> OTHER COMPANY <br /> 31GNATURE � REOISTERED Y/ N FE CURREA Y/N <br /> Address Licens # <br /> II RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans; 1)set of Energy Forms;R-O-W Permit for ew consUuctlon, <br /> Minimuin ten(10)working days after submittal d te. Requlred onsite,ConstrucUon Plans, tormwater Plans w/Silt Fence installed, <br /> Sanitary�FaclllUes 8 1 dumpster;Site Work Pe it;for subdivlsions/large proJects <br />-���l47MERCli�l Attach'(3)compiate ssts gf @uilding-P-lans p!us >life Safety_Page;(1)_set of Energy Forms.R-O-W Permit for new constructlon. , _ <br /> Mlnimum ten(10)working days aft�r submittai d te. Required onsite,Constructlon Plans, tormwater Plans w SITfFence`Instaile`d; -'-"`— <br /> Sanitary Facilities&1 dumpster.Site Work Pe It;for all new proJects,All commerclal requi ements must meet compliance <br /> SIGN PERMIT Attech(2)sets of Engineered Plans. <br /> '"'"PROPERTY SURVEY required for all NEW nstrucGon. <br /> Directions: <br /> FIII out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement Is requlred. {Af upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner) ould be someone with notarized letter fro ovmer authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicatlon O ly) <br /> Reroofs if shingles Sewers Service Upgrades A/C ences(PIoUSurvey/Footage) <br /> Drlveways-Not over Counter if on public roadways..needs RO <br />