Horry County - Permit Application Form

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HORRY COUNTY PERMIT
Flood Zone ___________
APPLICATION
BFE ______________
Panel # ______________
Approved ____________
Date _______________________________________
Name of Owner (as listed on tax book)___________________________________________________________________________
Address ___________________________________________________________________________________________________
Location of Improvement _____________________________________________________________________________________
Subdivision ________________________________________ Lot No. ________________Block No.___________ Units ________
Type of Work: New Improvement ( )
Alter ( )
Repair ( )
Add to ( )
Move ( )
Demolish ( )
Use of Improvements: Residential Single Family ( ) Mobile Home ( ) Duplex ( ) Apartment ( ) Commercial ( ) Institutional ( )
Warehouse ( ) Manufacturing ( ) Utility ( ) Other ( ) With Description ________________________________________________
Type of Construction: Frame ( ) Metal ( ) Wood ( ) Other ( ) Description ___________________________________________
Exterior: Brick ( ) Conc. Block ( ) Stone ( ) Brick Veneer ( ) Stucco ( ) Metal ( ) Wood ( )
Glass ( )
Vinyl ( )
Description _________________________________________________________________________________________________
No. of Stories __________________ No. of Bedrooms ________________No. of Baths_____________No. of Rooms____________
Type of Heating:
Hot Air ( ) Radiator ( ) Hot Water ( ) Steam ( ) Central Air-Cond. ( ) Other ( )
Heat Pump ( )
Type of Fuel: Oil ( ) Gas ( ) Electricity ( ) Wood ( ) Coal ( ) No. of Fireplaces ( ) __________________________________
Total No. of Square Feet _______________________Heated Space ___________________ Unheated ________________________
Remarks: __________________________________________________________________________________________________
Value of Construction $____________________________________________________
Building Permit
($
)
_______________
($
)
Permit No.___________________________________
_______________
($
)
State No.____________________________________
_______________
($
)
Mobile Home No._____________________________
_______________
($
)
Fire Receipt No._______________________________
Total Fee________
($
)
Contractor or Builder _________________________________________________________________________________________
Address _______________________________________________________Telephone ____________________________________
Architect or Engineer _________________________________________________________________________________________
Address _______________________________________________________Telephone ____________________________________
Estimated Date of Completion __________________________________________________________________________________
ROOM 244 * Tax Map _______________________________________________________________________________________
THIS PERMIT MAY BE SUSPENDED OR REVOKED FOR VIOLATION OF ANY REGULATION IN EFFECT BY
ORDINANCE OR OTHERWISE BUILDING PERMITS ARE NOT REFUNDABLE OR TRANSFERABLE.
The Application Above (Is or is NOT) Located in The Flood Zone Area.
_____________________________________________
Permit Issued By
___________________________________________________
Owner ( ) Contractor ( ) Agent ( )
_____________________________________________
Date

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