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813-780-0020 - - Fax 893-780-0021 <br /> * DWfu�ny✓v�+a�anrnLL <br /> Date Receivmd �� ` Phane Contac4 for P�rmtltin � �I . �� — �� �� <br /> Ownee°s P�ame Y Owwn�r Phon�@dum�er <br /> Owner'��dc9re�s `'( � l. �� �w+n�r Phone Plumb�r �— <br /> �ee Slmpl�Titl�hold�e Name Owner�hon�Rlurtnb�r <br /> Fee Simpla Yi4l�holder fiddress <br /> d0�A�DRES� �� u 1� �f`� • LOY e� � <br /> 5UBD1!lISIO�9 (,1 6 V�V C�r�l� � �A[�CEL ID� l,� ^ � - a - 4 i ' ��/ <br /> (08YI�INED FROM PROPERiTf TAX M0710E) <br /> liUORF���@OPOSED , e P1EW COfVSTR B ADD/ALT � SIGN Q Q DEMOLISH <br /> IfVSTALL REP/AIR <br /> PROPOSED=fJSE Q SFR Q COMM � OTHER <br /> YVPE OF COR15Ti3UCli0(d Q BLOCK ' Q FRAME Q STEEL � <br /> DESCRIPS'I�P!OF WORK 1� V �� '���1 � <br /> �UILDItdG St�E 5Q FOOTs�GE� 1iE1C9HT . <br /> QBUILDIiVG $ VALUATION OF TOTAL CONSTFtUCTION <br /> QELECTRICAL $ - AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBI�IG $ ���y'l � <br /> l�V �� � <br /> QMECHANICAL $ VALUATIt',1�t O�?�.=CHAN[CAL INST?�LLATION �� <br /> QGAS Q ROOFING .� SPECfALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOaD ZO�lE AREA QYES NO � <br /> Bl11LDER COMPAPVY <br /> �oc�,��ruR� REGISTERED Y/ N �cu�. YI� .. " <br /> Address License� <br /> El.EC�RICU�PI COAAPANY <br /> SIGR1d�TU� � REGISTERED Y/ iV .- �cuFtrtEn" Y!t�f . <br /> �ddeess Lfcense# - " - <br /> ,_ <br /> PLl1A�9BER CO�APARiY eU ,1 � I, (oL��O� , - <br /> SIGPiATUi3E RE(31STERED Y/-N FEE CURREA Y ' <br /> 6,ddress c� 1,� License# ��5• ^ _�a . V - <br /> t�JECiiAR11C�L CO�AP� <br /> SYCiP��'PUI3� REGISTERED Y/ N FEE CURREP Y/N _ ', <br /> �icYdr�as " License# � - <br /> O'�9�iER COtWP�1RN � ' . <br /> ��G�Y��� REGISTERED Y/ N_.. FEE CURRET Y 1 N ' , <br /> �dcYr�ss License# - <br /> �4�SID�R99'lAte _ •Attacti"'(2)Plot Plans;.(2)sets ofBuilding�Rians;(1)`se#of Energy�Fonns;R-0-1N Permit for new construction, � - � <br /> :Minimum.tem(10);working days.after"submittal date.:Required onsite,.Constriictlon Plans;Stormwater`Plans w!Silt Fence�s,��, . � <br /> �Sanitary Facilities&.1,dumpster SiteiNork<Permit for subdivlsionsAarge projects ` <br /> CORAilA��GI� Attach(3)complete seCs of Building°Plans plus a Life Safely Page;(1)set of Energy Forms.R-O-W Permit�Fornew cons'�u���.` <br /> Minimum ten(10)vuorking day�after submittal date. Required ons3te,Construc8on Pians,Stortnwater Ptans wl Sift F�ca��r�; <br /> Sanitary FaclliUes&7.dumpster.Site Work Permit for afl new projects.Ati comme�aal requlrements must meet camptiance" - <br /> SIGtU PERA�i7' Attach(2)-sets of Engineered Plans. _ <br /> ""PROPERTY SURVEY required for all NEVU con.sttuction. • • <br /> DIr�eBlons: - <br /> Ftll aut applicaUan completely. - _ _ -. <br /> Owner�Contractor sign back of applicadon,notarized � <br /> 1�ov�e$2500,�Flogtc�of�omm�ncemant is required. (A/C upgra�as over�7500) - . <br /> " t��:.�t(�or the contractor)or Power of Attamey(for ttie owner)would be someone with notarized letter from owner authorizing same <br /> �''u�-�=��i'T�R.PERAdlITTING (Front of Application Only) <br /> ;=*�"���-'-:� �=.-s Service Upgrades FJC Fences(Plot/5urvey/Footage) <br /> '��':�...����_�:s^��;.�2ys_.nseds ROW ' � <br /> :tT�` ,.f, . _., <br /> -r�::; , . ' - -_ <br /> t;=na.,y" , ., ,. .. <br /> �" •- :, �a�f��t�+^`3z, ^ , . �� ,. i _... . . <br /> ``.__ . ., ._ �`_,..._�_�;...«.�_..�..._._.,.- ' .��.._�_..�......_..-.."e_...... _ ' .- <br /> \ <br />