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813-780-0020 . Gtty Ot 4epnyrniii5 rUiiitiL t%I IJIII,QLI%Jli <br /> Building Department <br /> Date Received Phone Contact for Permitting., <br /> ...... <br /> Owner's Namer in (U LGS Lam_ Owner Phone Number <br /> Owner"s Address 6 1+� 1ri'1�S Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> t�, L j. <br /> JOB ADDRESS. <br /> -C J YYyf�', 11 r' ,4 �J3 LOT# <br /> .SUBDIVISION r PARCEL ID# I;L'2'�'"2� � 06'to Ut7500 _0056 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR ADD/ALT Q SIGN �] MOVE- 0 DEMOLISH. <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR C] COMM Q OTHER <br /> TYPE OF CONSTRUCTION. Q BLOCK Q FRAME 0 STEEL. Q OTHER 1 ^. <br /> DESCRIPTION OF WORK G RSt � <br /> BUILDING SIZE . I SC?FOOTAGE HEIGHT C <br /> Q BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ AMP SERVICE. I OQ PROGRESS ENERGY �] W.R,E.C. <br /> Q PLUMBING $ <br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> Q GAS CJ ROOFING. SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES ONO <br /> BUILDER FCOMPANY 7771 <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT' '_ Y I N <br /> Address License# <br /> ELECTRICIAN COMPANY Q r t h +l C. ICJ <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT LY/N J - <br /> Address 14W ` " I }" Q,�11 V License# E 60�3�5 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# ' <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y-/ N "` FEE CURRENT <br /> `Address License#' <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N J FEE CURRENT Y/N <br /> Address License# . <br /> WWI <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/Silt Fence installed, <br /> Sanitary Facilities.&1 dumps#er,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,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities-81 dumpster.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 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 />