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o��-,o„-,,,,�� cr <br /> ty ot Gephymiils Permit Applica#ion Fax-813-780-0021 <br /> i v . <br /> Bullding Department <br />� te Recelved phone Contact for Permittie — <br /> rner's Name ���� ����1�� �L� �ry�r Phone Number <br /> rner's Address �� lT� �� � G� Owaer Phone Number � <br /> s Simpte Titlehotder Name /��'S � Owner Phone Number ,_. <br /> e Simple Titl�holder Address <br /> � !Y1�l�J-�C9�it/'��.� ��,~`"' -,-,.-� � <br /> B ADDRESS �! C1 —% �OT# <br /> �eo�v�siaN � ' _ ` :S�K PAEtCBL IQ# �.3 21—c�1 cJ�6dDD� ����C� <br /> (OBTAINED PRQM PROPERTY TAX N0710E) <br /> )RK PROP08Eb NEW CONSTR� ADDlALT � SIGN [� Q DEMOLISN <br /> 1NSTALL REPA�R <br /> .OPQSED USE SFR Q COMM � 4TNER <br /> PE OF CON3TRUCTION BIOCK [� FRAME [� S7EEL � <br /> � rN��� �, � P f <br /> �mo� �x �..��l�r �t� <br /> SCRIPI'IOtd OF WORK <br /> i1L�ING SIZE �,_,__�� SQ FOOTAGE 2d�� HEIGHT [�� � <br /> IIDING � 9' � �� VAI.UATION OF TOTAI.CONSTRUGTII�N <br /> LECTRICAL ($ AMp BERViCE Q PROGRESS ENERGY Q W.R.E.C. <br /> �_ <br /> QPltlMBlNG ($�� <br /> L VAl.UATION OF MECNANICAI lf+tSTA�LATION <br /> QMECHANIGAL $ ��` `.,r <br /> . ,liv� <br /> �GAS [� ROOFING Q SPECIALTY � QTHER �i' �� <br /> �-r� � <br /> 11SHEd FLOOR ELEVATIONS FLOOD ZONE AREA [�YES NO <br /> ILDER :�/-1-CQ�—� PI�'CUP�/e� �A� � ' COMPANY l�-1�T��1�".�e�.-°�/� <br /> iFfATURE 1 f v� REGISTERED 'Y/ N FEE CURRE� /N <br /> Address 7�`p� ��11i�`LlI ��''• U'°��l`� �L. 3� Ucense# C cc �.���d'2z � <br /> eCTRtC1AN COMPANlt <br /> �NATURE REGISTERED Y J N FEE CURRE� Y/N <br /> Address Llcense# ( i <br /> JMBER � COMPANY <br /> ��pi'Y'(J�E REGISTEREO Y/ N FEE CURRE� Y/N <br /> � Address License# ( �� <br /> . <br /> ' CHANICAL CQMPANY <br /> NATURE RE�lSTERED Y! N FEE CURREF Y i N ' <br /> �' pd��� License# r�� � <br /> 1ER COMPANY <br /> NA7URE REGISTERED Y/ N FEE GURREt� Y i N <br /> - Addresa � License# �� "� <br /> itDEFITtAL Attach(2)Plot Plans;(2)sets of 8uililing Plans;(1)set of Energy Forms;R-O-W Permit for new aonshucdon, <br /> Min(mum ten(10)wor)cing days after submittal date. Requtred onsfte,Construction Plans,Stormwater Plans w!Silt Fence insta!led, <br /> Sanifary Facilities&i dumpster,Site Work Permit for subdlvislonsAarge proJects <br /> , AMERCiAL Attach(3)eomplete sets of Buildtng Plans plus a Life Safety Page;(1)set of Energy Focros.R-O-W Perm(t fo�new constructton. <br /> Minimum ten(10)working days�after submittal date. Required onsite,Constructfon Plans,Stormwater Plans w!Slit Fencs Instalted, <br /> ' Santtary Facllltles&1 dumpster.Slte Work Permit for all new proJe�ts.Afl commercia!requlrements must meet compliance <br /> N PERMIT Attach(2)sets of Engineered Plans. <br /> •`•"PROPERI'Y SURVEY reQuUed for all NEW construotlon; <br /> ictions: � <br /> , Fill out application campletely. <br /> Owner&Contractor sign back of appltcaUon,notarized <br /> ', If ovur 32500,a Natice of Commencement is requkgd. (A!C apg�ades over 57500) <br /> Agent(for the contractor)ar Power af.Attomey(for the awner}would be somea�e with notarized letter from owner autho�izing same <br /> ER THE COUNTER PERMITTING (Front of Applica8on Qnly} . . . ...: - <br /> �ofs if shingles Sewers Service Upgrades.A/G° ""Fenc�ss(PfoflSitrvey/Footage} <br /> p_.. , :,, _, _ „ <br /> Driveways-Not over Counter if an publlc roadways..needs'ROW , ,_ �. <br /> i <br />