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�,�-,o�.��� c.;ity ot�epnyrhiiis Permit Application FaX-813-?8d-0021 <br /> Bullding Department <br /> � � <br /> ,te Received Phone Contaat for Permittin — <br /> vner's Name � K+'�`� � � �a'�"' Owner Phone Number ___,__,_ <br /> rner's Address CJ.(c� qr it Owner Phons Nuntber <br /> e Simple Titlehatder Name Owner Phone Number � <br /> e 3lmple Titlehalder Address <br /> �8 ADdRESS C�i�' �..1'+''� LOT# � <br /> �BDiVISION � � � PARCEL!d# <br /> (dBTAiNED FROM PROFERTY TAX NOTIGEj <br /> � �RK PROPOSED e NEW CONSTR 8 ADD/ALT �� S1GN � Q DEMOLISH <br /> I 1NSTALL REPAIR <br /> I� :OPQSED USE Q SFR Q GOMM � OTHEFt <br /> �, PE OF CONSTRUCTION Q BLOCK [� FRAME � STEEI. Q <br /> ', ;SCRIPTtON OF WORK 4`� t� �- �� -L �i r C.— <br /> IILDING SIZE C— � SQ FOOTAGE HEIGHT ��� <br /> OSUILDiNG �� VAl.UATIQN QF TOTAL CONSTRUCTIQN <br /> ��LECTRICAt $ � , �, � AMP SERVtCE Q PROGRESS ENERGY Q W.R.E.C. <br /> [�PLUMBING �� <br /> C]MEGHANICAI $ �� VA�UATIQN QF MEGHANICAI INSTALIATtON ,�� ` <br /> QGAS [� ROOFING [� SPECIAl.TY �� OTHER <br /> 1 ,� <br /> tISHED FLOOR E�EVATIONS ��---� FLOOD ZONE AREA �YES NQ <br /> ILDER COMPANY <br /> itdATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> ; <br /> Address l.lcense# �— ' �� <br /> "cCTR1CIAN COMPANY �'/� /'/t � <br /> �NATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addrass t/ � 3 �t L G�rc'� License# ��l� C��1�?l�'� � <br /> 1MBER � COMPANY <br /> tNATUl2E REGISTERED Y J N FEE CURRE� Y/N <br /> Address l.icense# `— � � <br /> CHANICAL COMPANY <br /> NATURE REGtSTERED Y I N FEE CURRE� Y/N <br /> Address License# �i � <br /> � , <br /> IER GOMPANY <br /> NATURE REGIST�RED Y i N FEE GURREt� Y J N <br /> Address License# � � � <br /> �� ttDENTIAL Attach(2)Plot Plans;(2)sets of 8ultding Plans;(1)set of Energy Forms;R-Ct-W Permit far naw construc8on, <br /> Minimum ten(10j working days aRer submlttal date. Requlred anstte,Construotion Plans,Starmwater Plans w!Stlt Fence tnstailed, <br /> SaNtary Faci118es&1 dumpsker;Site Work Permit for subdivislansflarge proJects <br /> AMERCtAL Attach(3�complete sets of Build(ng Plans plu$a Ufe Safeiy Page;(1)set of Energy Foccns.R-Q-W Permlt for new cansbvallon. <br /> Minlmum ten(10j working days'afker submtttal date._Required onslte,Construetion Pians,Stormwater Plans w/Sift Fence instaEled, <br /> Sanitary Facilities&1 dumpster.Site Wark Pertnif for ap new proJeGts,All commetcfa!reqafrements must meet camptiance <br /> N PERMIT Attach(2)sets of Engineered Plans. � <br /> '""PROPERTY SURVEY required for aA NEW construcUon. <br /> ctlons: <br /> Ffll out application campletely. <br /> Owner&Conhactor siqn baok of applicatlon,notadzed <br /> If over 32500,a Noticgr of Commencement is requirad. {AtC upgrades aver�7500) <br /> Agent(for the contractor)ar Pawer of Attomey(for the owner}would be someone with notarized letter from owne�authorizing same <br /> -a ,..3�.::r..: <br /> �, ;R 1'HE COUNTER PERMITTING ' '(Front'of:ApplicaBon�Qnly} _ . <br /> �ofsifshingles Sewers Service.Upgr�di�s AlG ; .�, Fences,(PIaUSunreylFootage) <br /> Drlveways-Not over Counter if on publlc roadways..needs ROW . , . _ <br />