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o�3-�av-wcv c;rry or�epnyrni��s Permit Appticatian Fax-813-780-0021 <br /> Bulldtng bepafinent <br />� j <br /> Date Recelved � <br /> Phone Contaa4 for Permlttin ,� � -- t � <br /> Dwner's Mame W r�' /� � ;,,� � � I / � Gwner Phone Number 3+ ��� �3�� <br /> d r" `�l ,�s <br /> Dwner's Addresx � � c,.� jj'C�/"7� Owner Phone Number � <br /> Fee S(mpte Titteholder Name �� � Oumer Phone Number �� � <br /> Fee Simpte Tittehotder Address � <br /> i <br /> 1QS ADDRESS � ..... ._ t.?J Z ...... - .� ' �1 j'�I�. �4.S R- ����T# /j-• l L t �j���� <br /> �.� <br /> � <br /> 5UBDIV[SI{�N fq.�s.f c.•1 �4'1z.��`�-� PARCEL ID# � �� �/ - Cs cy ~—� G � G C3 O r� <br /> (09TAINED FROM PROPERTY TAX NOTICE) <br />, WORK PitOROSED � NEW CQNSTR 8 AQDtALT � SIGN Q Q DEMOLISH <br /> 1NSTALL REPAiR � <br /> PROPOSED USE [� SFR Q COMM [� OTHER <br />' TYPE OF CONSTRUCTION Q� BLOCK [� FRAME [ I � STEEL Q � <br /> DESCEtIP`I'ION OF WORK I < <br /> 9UILD!l�tG SlZE �3�j �f l � � SQ FOQTACsE �r.�1 � FlEIGHT C�� ' . <br /> QBUILDING $ ,�'� { c,,�+�� VA�UAT(ON OF TOTAL COI�iSTF2UCTlOI�f <br /> i � <br /> �ELECTRICAL � $ AMP SERVICE � [� pROGRESS ENERGY [� W.R.E.C. <br />' � r� <br /> QPLUM8ING $ �f �O' <br /> ` � � D �-�' �.�.�5 <br /> [�MECHANICAL ' $ VALUATION OF MECHANICAL INSTALLATIO�! ( ���P <br /> ( �� ,�cl�-r. <br /> QGAS Q ROOFING [� SPECIALTY 01 OTHER � �h.,�'-���� �L <br /> b�^-�=1NISHED FCOOR ELEVA'e IONS �FLOOD ZONE AREA QYES NQ 1 �"'���� <br /> 'i � <br /> J / �~ <br /> 3UILDER COMPANY �/� 1/C". �� a f v,.,�•-I ut�'+-3' - <br /> StC;FlATtlRE � � REGiSTEREd ' Y I ItI FEE CURRE� Y!N . <br /> Address i Cicense# � �� <br /> � � <br /> °_LECTRICIAN � � ����� CQMPANY ` � P I� <br /> ����A���� REGISTER6d , IV FEE CURREI� Y 1 N <br /> aaa�,�s �S'./'�` ���i f e '' �43�.��s � �.E��Se� �7 2. /% <br /> C r <br /> J � <br /> �LUMBER �\ti��rr�� A...� " COMPAMY � . �"— �.,.� <br /> 31GNATilRE ��z� ���.- t�E�ts���o � Y! N f�cuR En Y/N <br /> - Address 1 ��,,, � -�(y' , Li� l.tcense# �j�3� <br /> AECHANICAL ;h.� GOMPANY i D�� 1 / ���^'� <br /> i[GNATURE " R�GtS'fERED � N FfE GURRE� N <br /> � <br /> ,f 5'/�: �t�/ D � � � <br /> Address � � X�,� Lfcense# ���� �'/ '�'7�� � <br /> )THER CQMPANY <br /> �lGIdATURE REC�tSTERED � Y! N FEE ctaRSt�t� Y/(V <br /> Address II Ltcense# �� � <br /> I <br /> tESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy�Forms;R-O-W Permit for new constructian, <br /> Mfnimum ten{1p)working days after submittai.date. Requ}red onslte,Gonstructlon Pians,Stormvvater Pians wJ Sllt Fence Installed, <br /> Sanitary Fadlikles&1 dumpster;Site Work Permit for.subdivlsionsllarge projects <br /> :4MMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.Ft-O-W Permit for new construct(on. � <br /> Mintmam ten(1Q)working days after subrtt(ttai date. Ftequired onsite,Consttvction Plans,Staemwa#er Plans w!Sllt Fence lnstatled,_ <br /> Sanitary Facilitles&1 dumpster.Site Work Permit far all new proJects.All commerclai requirements must meet compllance <br /> �IGN PERMIT Attach(2)sets of Engineered Plans. ' ` j _ _� <br /> ""PROPER7Y SURVEY reqptred for ait NEW consUvcUan. E <br /> , <br /> iirections: � <br /> Fitl out appUcation campletety. ; <br /> Owner 8 ConUactor sign back of apptication,notarized <br /> If over 5250d,a Notice of Commencement Is requlred. (AIC upgrades ove{57500) <br /> ' Agent(far tt�e contractor)or Fower of Attamey{far the owner}would be someorte wtth natarized ietter from owner autharizing same <br /> iVER THE COUNTER PERMITTING (Front of AppUcaUon Only) <br /> .eroofs if shingtes Sewers Senrtce Upgrades A/G Fences{PIoUSurveylFootage} <br /> i <br /> Drtveways-Not over Counter if on public roadways..needs ROW <br /> ,,_ i <br />