Laserfiche WebLink
� <br /> uilding Department <br /> raTe,� "c� <br /> Date Recelved 'Z�3��� Phone.Con ct f.or Permlttin g 1 3 �' - �l�6 5 <br /> • � <br /> Owner's Name 2 �L � Owner Phone Numbe �L�- ���- �� i <br /> Owner's Address �sa 1 ��r`�o�'ZY jL� �a rac�0'# ��- Owner Phone Numbe � <br /> Fee Slmple Titleholder Name Owner Phone Numbe <br /> Fee Simple TltleholderAddreas <br />, JOB ADDRESS �S�6 ��-P `t"�O L}C,vdv 2.J 2. Z2P�/LyI�r�l/5 FL� ��JZ LOT# � <br /> SUBDIVISION � P 'RCEL ID# f�- -:�I- � !30 -� ��d °2�Z-� <br /> (OBTAINED FROM PR PERTY TAX NOTIGE) ' <br /> WORK.PROPOSED NEW CONSTR A �D/ALT Q SIGN Q Q DEMOLISH ' <br /> e INSTALL 8 R PAIR <br /> PROPOSED.UBE , Q. SFR Q C !NIM Q OTHER <br /> TYPE OF CON3TRUCTION Q BLOCK Q F .ME � STEEL Q <br /> DESCRIPTIONOFWORK �2eP��ce �'J�Wj :,� Ns�'S j� � epeNiAJ�s S S'�2�~`f/20G <br /> r-c 0�372 <br /> BUILDIN(3 SIZE SQ FOOTA(iE HEIGHT <br /> OBUILDING $ Z���'O� VALU TION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP ERVICE Q PROG ESS ENERGY Q W.R.E.C, <br /> QPLUMBING $ `�� �/ <br /> QMECHANICAL $ VALU TION OF MECHANICAL.INSTALLATION <br /> . L' 1 / <br /> QGAS Q ROOFING Q S ECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS F OOD ZONE AREA QYES NO <br /> G �,e a 12..Z'� <br /> � s ` <br /> � <br />� BUILDER OMPANY �Ow-eS i t�oM�, CeNT�2s 'nl�- <br /> SIGNATURE REGISTERED � Y/ N FE CURRE� Y/N <br /> Address � �p K � � ��J ��A ��' 3�'��� Licens # ��oL ( .s� o �l / I <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REGISTERED Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> PLUMBER � COMPANY <br /> SIGNATURE ; REGISTERED Y/ N FE CURRE� Y/N <br /> Address Llcens # <br /> MECHANICAL � COMPANY <br /> SIGNATURE REGISTERED Y/ N FE CUfZRE� Y/N ,. <br /> Address Licens #. <br /> OTHER COMPANY <br /> 31GNATURE REGISTERED Y/ N FE CURREA Y/N <br /> Address Licens # <br /> i <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Pians;l(1)set of Energy Forms;R-O-W Perm(t for ew constructlon, <br /> Minlmum ten(10)working days after submittal c�ate. Required onsite,Constructlon Plans, tormwater Plans w/Silt.Fence Installed, <br /> Sanitary•Facilitfes&1 dumpster;Site Work Permit,for subdivislons/large projects <br />-�OP1,�IERCI�l.-- _Attach_(3)cc�mplete_sets af Building_'lans plus Lifa Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcGon. <br /> Mlnfmum ten(10)workiny days�af;�r s�abniital-�ate�'Req�ired onsite,Construcdon Plans, tormwater Plans w/Slit Fence installed, <br /> Sanitary Facilities 81 dumpster.Site Work Perry�it�for all new proJects.All commercial requi ements inust meet comaiiance -- - -- — <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "'"PROPERTY SURVEY required for all NEW constructlon. <br /> Directions: <br /> Fill out application completely. <br /> Ovmer&Contractor sfgn back of application,notarized <br /> ,. If over 52500,a Notice of Commencement is requlred. ( IC upgrades over 57500) <br /> Agent(for the contractor)or Power of Attomey(for the owner)�nrould be someone wlth notarized letter fro owner authorizing same <br /> OVER THE COUNTER PERMITTIN(i (Front of Applicatfon O ly.) <br /> Reroofs if shingles Sewers Service Upgrades A/C ences(Plot/Survey/Footage) <br /> Driveways-Not over Counter If on public roadways..needs R <br />