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\ <br /> v�o-�ovwv�v c;ity ot�epnyrhilis Permit Applicatian FaX-813-780-0021 <br /> ����f�� Buiiding Depertment <br /> .t$Rec�ived�r ` Phone Contact for Psrmittin <br /> �aer's Name ,/� ,� �~' Owner Phone Numbar <br /> rner's Address ���� � � ���'�~���' 1° Owner Phons Number � � <br /> s Stmqla Tittehotder Narr�e �� � 1 Owner Phone Number � I <br /> e Simple Titleholder Address f � <br /> �S AdDRESS 1 V ��`` ��� LOT# � <br /> �BDMSiQN � � PARCEI.!D# <br /> (09TAINED pROM PROPERTY TAX NOTICE} <br /> )RK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> IN57ALl. FtEPAtR <br /> :OPOSED USE Q SFR [� COMM � OTHER <br /> PE OF CONSTRUCTtOt� Q BLOCK [� FRAME � STEEL. Q <br /> :scR���oN o�wa�K 1�`�'►47� �l{�'����'�''� �� <br /> �ILDING SlZE �- � 5Q FOOTACaE�� HEfGHT C�� <br /> BUILDINC., $ C,.��-�'.�,t ,u` VAlUAT10N OP TOTA�CQNST12llCT10N <br /> k.� t <br /> QELECTRICAL �� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBiNG � � <br /> � ���QMECNANICAi. $ VALUATION OF MECHAN�CAL INSTALLATION <br /> QGAS [� ROOFING Q SPECIAITY � OTHER <br /> 1tSHED FLOOR ELEVATtONS �— � FLQOD ZONE AREA QYES NO <br /> i .�� <br /> %,/'��,=�—=�.�'. �r�-Q�(� j\.A�..� <br /> ILDER �. ����,,.�- COMPANY �S�~�---� <br /> iNATURE ;;�'��' REGISTERED Y/ N FEE CURR6� Y/N <br /> Address `� ��,bvt I�t.� Llcense# �� � � <br /> ECTRICIAN COMPAMY <br /> iNATURE REGISTEREd Y/ N FEE CURRE� Y/N <br /> Add�ess Llcense# �— ��� <br /> 1M8ER � � COMPANY <br /> �NATURE REGtSTERED Y! N FEE CURRE� Y/N <br /> Add�ess License# ��� �� <br /> GNANiCAL COMPANY <br /> NATURE REGiSTERED Y 1 N FEE CURREh Y/N <br /> Address License# � —�� <br /> !ER � COMPAPIY � <br /> NATURE RfGiSTEf2Ed Y I N FHE CURi2Et+ Y/IV <br /> Address License# �` i� <br /> tIQENTIAL Attach{2)Plot Pfans;{2}sets of BuHding Plans;(1 j set of Energy Forms;R-d-W Fermit far new canshvction, <br /> Minimum ten(10)working days after submittal date. Required ansite.Conshuct(on Plans,Stormwater Piar►s wl SNt Penae inata(led, <br /> Sanitary Facitities&.t dumpster;Stte Work Permtt for subdfvislonsAarge projects <br /> AMERCIAi. Attach(3}complete sets of Buildtng Plans ptus a life Safety Page;(1)set of Energy Farms.R-O-W Perm(t for new constructlon. <br /> _ Minimum ten{10)working days after submittal date. Requfred onsfte,Canstructton Ptans,Stormw�ter Pians wt Silt Fence instatled, <br /> Sanitary Facllitles&1 dumpster.Site Wark Permit har ail new proJects.All commercial requirements must meet compliance <br /> N PERMlT Attach(2}sets ot Engineered P1ans. <br /> ""PROPERTY SURVEY requlred for a!I NEW construc@on. <br /> ctio»s: <br /> FUI out appllcation campletely. <br /> Owner&Contractor sign back af applfcation,notarized <br /> tf over$250d,a Natice af Commencement Is requirgd. (A!C upgrades over 37500) <br /> Agent(for the contractor)or Power of Attomey(for the awrter)wautd be someone with notarized letter from owner authorizfng same <br /> iR TNE C011HTER PERMlTTING (Front of Appiication Onty} <br /> �ofs if shtngles Sewers Service lJpgrades A!C Fences(P1oUSurveytFootage} <br /> Driveways-Not over Counter if on pubtic roadways..nesds ROW <br />