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I <br /> r <br /> Building Departinent ' <br /> I <br /> t'�=A <br /> Date Received �- � ' ' � <br /> Phone.Contact for Permittin �'6 t j Z- ' q - `3 9 fo S <br /> . <br /> Owner's Name �i.�� i'e �e 13R 5 p�y Owner Phone Numbet �'l"3 '`�$$- (o�6 S <br /> — I <br /> Owne�'s Address �l 1 g /gTh S7' Z2Pl�y�r/!S FL 3� ��" p�er Phone Number <br /> , � <br /> Fee Stmple Titleholder Name � Owner Phone Numbej � <br /> � <br /> I <br /> Fee S(mple Titleholder Address C I <br /> JOB ADDRESS 6 Z�S I $Tf, ST 'ZQP��'-Y��1!5 FL 3 3 SY Z LOT# Y� <br /> i i <br /> SUBDIVI�ION ZP.� �/L. _2..� PARCEL ID# ��-�b-z!-o i9e--o!voar> - u�oc�� <br /> I (OBTAINED FROM PROPERTY TAX NOTICE) ' <br /> i WORK P�20POSED e �NEW CONSTR B ADD/ALT Q ! SIGN Q I Q DEMOUSH i <br /> IN81'ALL REPAIR ' j <br />� PROPOSED.U8E Q SFR Q COMM C] � OTHER ' <br /> TYPE OF CONSTRUCTION Q BLO��CK Q FRAME � j STEEL Q � <br /> D�� i � <br /> DESCRIF'TION OF WORK �r jAC2. I �� ,2 titNiT Siz.�.�.5:�7� I-L �2i� �`� <br /> BUILDIN�SIZE I SQ FOOTAGE� � HEIGHT ; <br /> �UILDING $ VALUATION OF TOTAL CbNSTRUCTION I <br /> !230. �� , <br /> � <br /> [�]ELECTRICAL �� AMP SERVICE ! Q PROGf�ESS ENERGY Q W.R,E.C. <br /> I � <br /> C]PLUMBING $ ' � I �O�l� <br /> �� � � � � <br /> C]MECHANICAL $ VALUATION OF MECWANICAL.INSTALLATIONi <br /> �� � � <br /> i <br />' C]GAS Q ROC�FING Q SPECIALTY �] ; OTHER � <br /> i FINISHEp FLOOR ELEVATIONS �� FLOOD ZONE AREA i QYES NO <br /> Q o � , G ��� �� <br /> �� �� ; , <br /> � <br /> �ow-es. l oM N`T� � <br /> d �C <br /> I 2� <br /> BUILDEFt Y e, e <br /> - <br /> SIGNATtIRE REGISTERED ' Y/ N FEE CURRE� �Y/ <br /> Address D �O`� O �I� Q�'�-�A��<' � 3;`�"�7 y Licens�# �.�oG .S(� � I <br /> — � ; � <br /> ELECTRICIAN COMPANY I <br /> 51GNATURE REGISTERED Y I N FEE CURREt� Y I N <br /> I <br /> Address �— ; License# � <br /> ' I <br /> PLUMBER COMPANY � <br /> SIGNATURE REGISTERED � Y/ N FEE CURRE� Y/N <br /> Address Llcense# <br /> MECHA�BICAL COMPANY <br /> SIGNATIIRE REGISTERED � Y/ N FE i CUFiRE� Y/N <br /> I (� <br /> Address � Ucens�# I <br /> � � <br /> OTHER COMPANY � i <br /> 31GNATlIRE REGISTERED . Y/ N FEE CURRE� Y I N <br /> _ , <br /> Address � Licens$# <br /> tfii <br /> FtESIDENTIAL Attach(2)Plot Plans;(2)sets of Bulld(ng Plans;(1)set of Energy Forms;R-O-W Permit for(��ew constructlon, <br /> Minimum ten(10)working da�ys after submittal date. Requfred onsite,�ConstrucUon Plans,Stormwater Plans w/Siit Fence installed, <br /> Sanitary.FaGllUes 81 dumpster;Site Work Permit for subdivlslonsAarge proJects � <br />- COMMERC.IAL._-Attach_(3)_camplete sets of Bvildtng Plans I�us a Life Safety_Page;(1)set of Energy Forms�R-O-W Permit for new wnsUuctfon. <br /> Mlnlmum ten(10)working da�ys after submlttal date. Requlred onsit�e�onst�uoffon Pians;Stormwaier Ylans w/Silt�Fence-instailed; --� - - - <br /> Sanitary Facilltl�s 8�1 dumpster.Site Work Permlt for all new projects.All commerclal requi�ements must meet compllance <br /> SIGN PERMIT Attach(2)sets of Englneered Plans. � <br /> ""'PROPERTY SURVEY requlred for all NEW construcUon. ' <br /> ��2 � <br /> Dlrections: <br /> FIII out applfcatlon completely. ; <br /> Owner&Contractor sign back of app8catlon,notarized ! � <br /> If over 52500,a Notice of Commencement Is requlred. (AIC upgrades over 57500) i <br /> •' Agent(for the contractor)or Power of Attomey(for the owner)would be someone wlth notarized lettar froni owner authorizing same <br /> OVER TFIE COUNTER PERMITTING (Front of Appllcatlon Only) ; <br /> Reroofs If sh(ngles Sewers Serv(ce Upgrades A/C Fences(Plot/Survey/Footage) ; <br /> � <br /> Drlveways-Not over Counter If on public roedways..needs ROW � <br /> I <br /> I <br />