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_._ .__ ___.. t..+cy vr Lepnym�ns rerm�t p►ppi�cation F2x-813-780-0021 <br /> Bu{Iding Departme�t <br /> �tate Reaeiveci �j__ - � '.J'"� phone Contact for Petmltting � j�'°3" "`-�'z`'S'�C� <br /> � f�� �'i��.e-=�c�� Owner Phone Number ^� �. `� � �'�-�O <br /> Dwners Name ct-.� � � <br /> Owner's Address �`' �.-/`�� �v � '"Z � CMmer Phane Number � <br /> Fee Simple Titlehatdsr Name ( � � Own�r Phone Mumber _„_„_„_._._ <br /> Fee Simpie Tltiehofder Address <br /> l^3`��- (�'�`� <br /> JOB ADDRESS 0 - �'�7$�.� - �G c -� .� ?8'�""� �►'`1 t r�,t -� LOT# 4��-� <br /> LaG <br /> StlBDNISIDN �.sA-�iu�.•."I 2�cs U-�-� PARCEI.ti3# -^� �"'� -- G o�a � � d C, G cs� <br /> (OBTAtNED FROM1i PROPERTY 7AX NOTiCH) <br /> W(!RK PROPOSED NEW CONSTA ADD/Al.'C �� SlGN [� Q DEMQlISH <br /> IMSTAI.I. 8 REPAIR <br /> PROPOSEU USE C] SFR Q COMM [_] OTHER <br /> TYPE OF CONSTltUC'iION ��gLOCK [� FRAME � STEEF. [� <br /> DESGRIPTION OR W R L�Lr�1 � � � <br /> BUllOINt3 SlZE 0�"Il � SQ FOOTAGE�� HEIGHT ��� <br /> QBUtLDING � �_,.,-- �-� VALUATiON OF fiOTA�CONSTRUC7iON <br /> 7� <br /> 'I �]ELECTRICAI. $ � AMP SERVICE � PROGRESS ENERGY ��R.E.C. <br /> ,�.�-� . <br /> I QPLUMBtNG $ � �T��S��r ,�Jr� <br /> �, � Z�°��°����� � -�� <br /> �]MECHANICAL $ VALUATION OF MECHANiCAI INSTALLATION �5 3(o-'u''t+f <br /> C]GAS Q ROOFING [� SPECiALTY � OTNER (� <br /> =1NISHED FLOOR ELEVATIONS FLOOQ ZQNE AREA QYES NO �� <br /> �..,_� <br /> � <br /> e <br /> 3UIl.dER �~t �/'' ��/ r COMPANY `' ., � <br /> 51GNATURE !�- `��y�/3�`�"`��/^'� REGISTERED Y/ N FEE CURRE� N <br /> Address � `�"�r�•..�f�-� �tc�nsa# � � � <br /> ?LEGTR1CiAN Jy� COMPANY /I �l�Gi c.- <br /> �tGNATURE /�' REGISTERED Y! N FEE CURRE� Y/N <br /> Address �lt�nse# �a 7 '�.- � <br /> i ��unna�az .� ����� � conn�ANV �, � �- � <br /> �tGT�ATURE `�'�"�`''�^��ti i\:1" " �''�.� � REGISTERED Y/ N E8 CURREh Y/N <br /> Address �� � � � •• � Uaense# ���,�,���tZ�,�}� <br /> AECNANICAL ��� � COMPANY �AHR$ �,Co .v G .�r,rt„f'2/G .Ti�'C. <br /> 3lGNATURE REGISTERED Y/ N FEE CURRE� Y/ <br /> Address y 1�i�L✓ I� /�i. ' .f" Ucense# �Gd `1-��Y 8 � <br /> )THER COMPANY <br /> �IGNATURE REGlSTERED ' Y/ N FfE fit1RREM1 Y J N <br /> Address Ltcense# �— �� <br /> tESIDENTIAL Attach{2)Plot Plans;{2)sets of Buildtng Plans;(1)set of Energy Fotms;R-O-W Psrmif for new constructlon, <br /> Mlnimum ten(10).working days after submltta!_date. Requlred onslte,ConstrucUon Plans,Stormuvater Ptans wt Slft Fence instatled, <br /> Sanitary Facllitles&1 dumpster,Sfte Work Permlt ior subdlvisfanstlarge proJects <br /> :OMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R O-W Pertnit for new construction. <br /> Minlmum ten(10)working days aftsr submitta!date. Raqulred onsfte,Constructfon Pians,Starmwater Plans w/SiIC Fence installed, <br /> Sanitary Fac(lities&1 dumpster.Slte Work Permit far ail new praJecEs.Ait c�mmercEalrequirements must meet compliance <br /> �IGN PERMIT Attach(2)sets of Englneered Plans. <br /> ••"•PROPERTY SURVEY requlred for al!NEW construcUon. <br /> iirectlons: <br /> Fill out appltcation complstely. <br /> Ovmer 8�Contractor sign back of appllcaUon,nota�ized <br /> , !�over�,7.5�0.a NoUce ot Commencsment ts requlred« (AtC upgrades over S750Q) t� <br /> ' Agent(for the contractor)or Pawer of Attomey(for the owner)wouid be someone wrlth notarized letter frnm owne�authodxing same <br /> lVER THE COUNTER P�RMIT[ING {Front,of Appllca�on Onty) . - -. . _ <br /> teroofs Ii shingles Sewers Servfce Upgiades A!C Fenaes{Ptot/SurveyJFoatage) � <br /> Driveways-Not aver Caunter if on pubitc roadways.:needs ROW • ' , <br /> . � � / <br />