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o��-������ �iry ot�ephymills Permit Application Fax-813-780-0021 <br /> Building Department <br /> te Received , Phone Contact for PermittU SoZ ��. — �` �� � <br /> rner's Name lLcc1/1 (.�.� Owner Phone Number /�� � 0�' b 7� <br /> rner's Address 7�`� • r'/�v'� Owner Phone Number <br /> e Simple Titleholder Nam� Owner Phone Number <br /> B 3imple Titleholder Address <br /> B ADDRESS IL�LQO � LOT# � <br /> BDIVISION PAttCEL ID# r� � ( o�I O'!a 0 6 O C�0 Q /D�G3 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> )RK PROPOSED B NEW CONS7R B ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> .OPOSED USE Q SFR Q COMM � OTHER <br /> PE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> SCRIPTION OF WORK �f/- � �/ Gr K'!.� /`/J <br /> iILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> MECHANICAL $�i�n� /�� VALUATIOM OF MECHANICAL INSTALLATION <br /> i�OC v�� <br /> QGAS Q RO.OFING Q SPECIALTY Q OTHER <br /> IISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> ILDER COMPAWY <br /> iNATURE _ — - REGtSTERED "'"-- Y-/ N- FEE CURRE� Y/N �' J <br /> Address Ltcense# <br /> °_CTRICIAN COMPANY <br /> INATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> JMBER COMPANY <br /> �NATURE REGISTERED Y/ N ,FEE CURRE� Y/N <br /> Address License# <br /> CHANICAL COMPMIY /`/ �`C O� CI <br /> NATURE REGISTERED Y N FEE CURRE� /N <br /> Address o� 02 liJ , � Q C� ,."� /%/• 5�.� License# <br /> �ER COMPANY <br /> NATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � Ucense# <br /> i1DENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Pertnit for new c:onstrucdon, <br /> Minimum ten(10)woricing days after submittal date. Required onstte,Construction Plans,Stormwater Plans w/Silt Fence tnstalled, <br /> Sanitary Facilitles&1 dumpster;Stte Work Permit far subdivisions/large pro)ects � <br /> AMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Ehergy Fortns.R-O-W Permit for new construcHon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Pertnit for all new proJects.All commercial requirements must meetcompliance <br /> N PERAAIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for ali NEW construction. - � � � <br /> cllons: <br /> FIII out applicaHon completely. <br /> Owner 8 Contractor sign back of applfcation,notarized <br /> if over a2500,a Notice of Commencement is required. (A/C upgrades ovar a7500) <br /> Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> iR THE COUNTER PERMITTIMG (Front of Applicatlon Only) <br /> iofs If shingles Sewers Service Upgrades A!C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if an public roadways..needs ROW <br />