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813-780-0020 City Ot/—epilyrrtiiis rt ItIIt^VV. 1.L1u1I <br /> Building Department <br /> Date Received <br /> 6 G Phone Contact for Permittinaim <br /> Owner's Name R.obgA` IL n �JDv c .t' Jt Owner Phone Number <br /> Owner's Address <br /> Owner Phone Number -- <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS (!54 b �oZ_i'Y1:IJoy' .-b C. t'�►z�L1 LOT <br /> .SUBDIVISION. ' 16-I V'Q{`Wc %_\ksx'C)')e-� PARCEL ID# 0 3' oob o-.o 53 6,: <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW'CONSTR ADD/ALT Q ,: SIGN [� MOVE = DEMOLISH ` <br /> e INSTALL e REPAIR <br /> PROPOSED USE = SFR 0 COMM Q . OTHER 177 <br /> TYPE OF CONSTRUCTION BLOCK—. FRAME 0 STEEL = OTHER <br /> DESCRIPTION OF WORK �%�� <br /> BUILDING SIZE S4 FOOTAGE HEIGHT, <br /> = BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ AMP SERVICE PROGRESS ENERGY: <br /> = PLUMBING {$ <br /> MECHANICAL �$ VALUATION OF MECHANICAL INSTALLATION v j <br /> = GAS Q ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS �{ FLOOD ZONE AREA =YES ONO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT. <br /> Address License# I - <br /> ELECTRICIAN AsoCOMPANY • +r1 ..htf,SIGNATURE REGISTERED Y! N FEE CURRENT Y/N <br /> Address ,�.�3b* lam.a e �-t 3S Licerise# t?3'Dt3 }?�. <br /> 3'3 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N' FEE CURRENT <br /> Address License#•.. �- `. <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Slit Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL 'Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new•construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans;Storinwater'Pians w/Slit Fence installed, <br /> Sanitary Facilities&1.dumps`ter.-Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans.-' <br /> - `***PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized- <br /> If <br /> over$2500,a Notice of Commencement is required. (A/C upgrades over$5000) <br /> *' Agent(for the Contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways.;needs ROW <br />