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__ <br /> o,.a-�o�-w�V t;ity ot�ephymiiis Permit Applicatian Fax-813-780-dd21 <br /> Bullding Department <br /> . <br /> ts Receiva�! Phono Cantact for Permtttin <br /> rner•s Nama p� Qwner Phons Numbe�r f�� ���'l�J <br /> mer's Address ��J 7 7 // / ./"T�` Owner Phane Number �^ � <br /> �Simple Titlaholder Name � �� Owner Phone Number � � <br /> s 8imple Tittehoider Address <br /> B ADDRESB L.OT# � <br /> 'BDIYISION ( �"�.JO`a.t�t,t(/ �'d?'r 3�'� PARCEI.IQ# 7 � � ts'� V ' t1t1V Q� �7�� <br /> (OBTAINED FRdM PR PERTY TAX NOTlCE) <br /> )RK PROPOSED e NEW CONSTR 8 ADD/A�T � SIGN Q Q DEMOLISH <br /> INS7ALL REPAtR <br /> .OPOSED USE Q SFR Q COMM � OTHER <br /> PE 8F CONS7RUCTiON Q BLOCK Q FRAME C� STEEL Q <br /> SCRiPTiON OF WORK ��t..._ � C X 1 S i � TL�� t��+' <br /> iILQING SI2E ��� 8Q FOOTAGE�� HElGHT [�._.� <br /> QBUILDING t6`-r� VALUATtQN OF TOTAL CON3TRUCTIQN <br /> � <br /> QEL.ECTRICAL �.� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPL.UMBING �� <br /> �tNECNANICAi. $�jj���ry ��,,,,,1� VALUATION OF MECHANICAL INS7ALLATION <br /> 7 7` ��" t1c✓ <br /> C]�AS Q ROOFiNG C] SPECtALTY [� o��R <br /> (ISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA QYES NQ <br /> ILDER COMPANY - <br /> iNATURE __ _ ._ �_ �REGISTEREO Y/ N FEE CURRE� Y/N <br /> Address Llcense# �— � <br /> ECTRICIAN � COMPANY <br /> i�IATURE REGISTEREd Y/ N FEE CURRE� Y/N <br /> Addra�s License# �— �� <br /> )MBER � CdMPANY <br /> �NATURE REGISTERED Y I 1d FEE CURRE� Y/N <br /> Address License# �— � <br /> CHANICA! COMPANtY � t�"i.S /"" `� O <br /> NATURE � REC71S'(ERED 1 (V FEE CURRE� I R) <br /> Address � �,}�-��� Ucense# ��Q ���f�"� <br /> iER COMPANY <br /> NATURE REGIST�REb Y I N FEE CllRREh Y/N <br /> Address License# �� � � <br /> ilDENTlAL Attach{2)Ptat Pians;(2)sets of Bu3lding Pians;{1)set of Energ}r Forms;R-O-W Permlt for new canstructton, <br /> Minimum ten(10)working days after submittal date, Requtred onsite,Conshuctton Plans,Stonmwater Plans wt 38t Fence finsta{led, <br /> Sanitary FaciltUes&1 dumpster,Sike Work Permit for subdlvislans/large projects <br /> AMERCIAI. Attach{3}complete sets of Buitding Plans qtus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new conshuctian. � <br /> Minimum ten{10)worktng days after submittal date. Rec}uired onslte,Constructlon Plans,Stormwater Pians w!Sift Fertce Instalfed, <br /> 5anitary Factlities&1 dumpster..Site Work Permit far all new projeats.All commercial requlrements musYmeet compflance <br /> N PERMIT Attach(2}sets of Engineered Pians. <br /> """PROPER7Y SURVEY required for al!NEW constnaction. <br /> c#1ons: <br /> FIII out appllcallon complekely, <br /> Owner&Cantractar sign back of appitcatlon,nota�ized <br /> if av�r�250d,a Notice af Commencem�nt is required. (A/C upgrades over$7500) <br /> Agent(for the cantractar)ar Power of•f�ttom fdr`th`e`owrier.woutd be someohe anth no#arized letter from owner authorizfn same <br /> , �Y't ).. 9 <br /> , _. ,�- <br /> iR THE COUN7ER PERMtTTING :. (�ront of ApplicaBon�Oniyi} � <br /> +ots if shtngles Sewers Seivice,Upgrades�RlG���°�Fences(P1oUSunreyiFoo#age} <br /> 3 �,..... .. „, ,: � . _ , <br /> drivswayswNot over Cdunter if on pubtic roadways::need�RbW`" ` ��q <br />