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813-750-0020 City of Gepnyrnills Permit Application rax-ala-iav-uuc i <br /> Building Department <br /> Date Received p� :!� Phone'Contact`forPermitting— — <br /> Owner's Name Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> Fee Simple!TitleholderName Owner Phone Number, <br /> Fee Simpleltitleholder Address <br /> JOB ADDRESS (O / LOT# <br /> SUBDIVISION PARCELID# Q-d - Q <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR` ADD/ALT Q' SIGN 0 [� DEMOLISH <br /> B "INSTALL B , REPAIR <br /> PROPOSED,USE. = SFR Q `COMM OTHER <br /> TYPE'.OF CONSTRUCTION 0 'BLOCK = FRAME = STEEL Q. <br /> DESCRIPTION OF WORK <br /> -BUILDING:SIZE SQFOOTAGE HEIGHT <br /> =BUILDING $ VALUATION'OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OCAS 0, ROOFING 0. SPECIALTY. = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> •-BUILDER _ COMPANY <br /> SIGNATURE REGISTERED Y-/-N. - FEE CURREI, <br /> Address -License.# <br /> =.''ELECTRICIAN COMPANY <br /> _`SIGNATURE <br /> REGISTERED Y/ N . FEE CURREn Y/N. <br /> Address: License# <br /> P.LUMBER COMPANY­,, <br /> -SIGNATURE REGISTERED Y/'N•`: ': .FEE CURREN L Y/N <br /> Address - ; License#'.1.7 <br /> MECHANICAL' '_ • COMPANY <br /> `SIGNATURE'.' ' " REGISTERED Y N FEE:CURREK N <br /> Address'>r-` / d License.# <br /> OTHEW-,,*�,,t>;:...:;. .77 -COMPANY <br /> SIGNATURE,?.j t;: -REGISTERED Y/.N FEE CURREN Y/N <br /> License`# <br /> ;> <br /> k:RESIDENTIAL> r.'Attach' RPIot:P.;lans;;'12 aefsof Buildin"Flans; 1<<set'of=Ene�''`'Forms R.Q=V11 Perrriit:for new.constniction <br /> _. <br /> -x: -f .Minimumi ten6(10)tivitorkin'days'afte'1-dbinittaVdate."Required`onsite:Construct on Plans,Stormwat Pla <br /> ns ans id'silt Fence.installed, <br /> Sanitary`,% litiei,4,&dumpste[;;Sife 4Work:Pbrm_it:for.•subdivisions/large <br /> ,;:COMMERCIAL Attabt j2)complete''sels oftailding 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%Siit Fence installed; <br /> Sanitary•Facilities&1 dumpster.Site Work Permit for%all new-projects.All commercial requirements must meet compliance - <br /> ..SIGN;PERMIT "Attach=(2)sets of Engiriee�ed Plansat>.,=.° <br /> ""'PROPERTY SURVEY.required for,ail,NEW,cons"ction..,.. <br /> ryDi�ectionsr :i._... .»• . <br /> FIII'out?application completely. ,. <br /> -Owner'&`Contractorsign:backofapplication,notarized <br /> If over'$2500;.a Notice.of.Commencement is required. (A/C upgrades over$7500) <br /> A ent`forth'd�dbntMctot'-or-Power-'of'Attome for'the owner wiould`lie someone with notarized letter from owner authorizing same <br /> 9 ( � ) Y( ) 9 <br /> �OVER.THE COUNTERPERMiTTING. (copy_ofcontract.required) <br /> {"Reroofs if'sh holes Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public'roadways Addds ROVU <br />