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catty of cepnymius Permit Application Fax-813-780-0021 <br /> Building Department p r t r <br /> Date Received '� ✓l�} phone Contact for Parmittin -- �" / - V�/ _ <br /> Owner's Name r- N Owrtsr Phone Number " �3 J�7 � <br /> Owner's Address �7 �J� ,rt� Owner Phone Number j� <br /> Fee Simple Titleholder Name ,Ownsr Phone Number. <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS h SJRti�1 LOT# s�h Ih{ !i <br /> SUBDIVISION PARCEL ID# <br /> (08TAINEO FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED Ml NEW COWSTR� ADD/ALT Q SIGN �} Q DEMOLISH <br /> [� INSTALL REPAIR i <br /> PROPOSED USE (_ 'SFR Q COMM' C] OTHER ` <br /> TYPE OF CONSTRUCTION = BLOCK • _' FRAME 0 STEEL = <br /> DESCRIPTION OFrWORK rk 66T �( }feu. ,i,n se 54; f <br /> BUILDING sta 1 !46 x 0 SQ FOOTAGE HEIGHT a q.> <br /> sUiLDING T< <br /> goo VALUATION OF TOTAL CONSTRUCTION <br /> = I <br /> =ELECTRICAL AMP SERVICE = PROGRESS ENERGY Q W.R. <br /> ]PLUMBING. <br /> =MECHANICAL '( VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING M SPECIALTY OTHER. � - <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO 00� <br /> I <br /> --� <br /> BUILDERi, COMPANY �� u c Wpw CcAQ-tick;cN Iva. I " <br /> StGNATURE ._f I <br /> REGISTERED I YM FEEcuRREr Y•1N <br /> Address " low teal, License# as <br /> ELECTRICIAN COMPANY ^� <br /> SIGNATURE REGISTERED I Y/N FEE CURREn. <br /> Address Ucense# <br /> PLUMBER COMPANY <br /> REGISTERED Y/N FEE CURREn Y/N. I <br /> SIGNATURE <br /> Address License#i <br /> MECHANICAL. COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURREa Y/N LL <br /> Address /} 3 License# ��✓<T <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN <br /> Address License#] l <br /> RESiDENTLAI. Attach(2)Plot Plans;(2)sets of Building Plans,(1)set of Energy Forms:R-O-W Permit for new construction. <br /> Minimum ten(1O)wondng days afW.submtttal data: Required onsite,Construction Plans.Stwmwater Plans w/Siit Fence installed, <br /> Sanitary Facilities&1 dumpater,Sits Work Pemdt for subdivislonsRerge pmjects i. <br /> COMMERCIAL. Attach(3)complete seta of Building Plans plus a'Llfe Safety Page:(1)setof Energy Forms.R-O-W Permitfor 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.Sfts Work Permit for all new projects.All commercial requirements must meet compliance I <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. . <br /> -PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Flli out application completely. <br /> Owner&Contractor sign back of appiication,notarized <br /> If over$"00,a Notice of Commencement is required. (A/G upgrades over$7500) <br /> " Agent(for the ocnttaaor)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 If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways-niseds ROW <br />