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VI Ly UI.Z_CPI lyl l IIIIto TGI'r I IIL/-%PPIIUdLIUI i ran-o�a-i ou-uu�i <br /> Building Department <br /> )ate;Received <br /> p '" �!' ' <br /> • - P rm Phone Contact for Peitting f�� . ) ��r —: � I�.— <br /> 1�1-1�r1�Z— <br /> )wneesName u.)�C II&I L /'�U1� )G{.flc: � <br /> P G Owner Phone Number <br /> 2t��2 S, Falle�nbt,tre iverlll'¢ <br /> 3wner's Address ) Owner Phone Number <br /> ree Simple Titleholder Name Owner Phone Number <br /> -ee Simple Titleholder Address, OX <br /> li ; <br /> f,�.�Q /� f <br /> IOB ADDRESS �J 'V" fir . DDdS F�� llll5 �L 335g2 LOT# D <br /> WISDIVISION Dt/i/ S D. � SGp PARCEL ID# ' 'gl—012V 000V(J' (iCJ <br /> (OBTAINED FROM PROPERTY TAX NOTICE):'. <br /> YORK PROPOSED : NEW CONSTR ADD/ALT SIGN ; Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE FX7 SFR. COMM <br /> 0 O OTHER <br /> TYPE OF CONSTRUCTION .. 'BLOCK Q FRAME STEEL = <br /> )ESCRIPTION OF WORK. Ivi 0 evh4-tZZ A art ,;n <br /> WILDING SIZE ` 1_1 l V�I SQ FOOTAGE HEIGHT` <br /> QBUlLDlNG $ 135 V�� f) VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL - : $ AMP SERVICE PROGRESS ENERGY, 0 W.R:E.C. <br /> n <br /> =PLLIWING $ lit�...e: ��GL� <br /> =MECHANICAL $ VALUATION OF MECHANICAL:INSTALLATION <br /> =GAS -• . Q ROOFING SPECIALTY 0 OTHER <br /> =1NISHED:FLOOR ELEVATIONS : : " " 1 :: FLOOD ZONE AREA- - - YES NO <br /> 41 , 1(;� <br /> BUILDER COMPANY : . GLL G C <br /> SIGNATURE REGISTERED: Y/N N � <br /> .:Address �O�I�S�: .Cil n1�er � lde/1/oP,u)l���33�`�.. License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N. FEE CURREN LILN <br /> Address ! h. <br /> License:# EC <br /> �oD ?�� <br /> PLUMBER COMPANY V/�:1 V1 1 b: 0 1 <br /> SIGNATURE REGISTERED Y./ N FEE CURREN Y/N <br /> Address License# <br /> l <br /> MECHANICAL. COMPANY R& f�S/TY (U`G/ If fI *l �I <br /> SIGNATURE REGISTERED Y/ N' FEE CURREN Y/N- <br /> 913 De tm Ave Gt5�1,FL 3�l'�(v? : License# Z� <br /> Address <br /> OTHER COMPANY.. . GG. <br /> SIGNATURE REGISTERED Y/ N. FEE CURREN Y/N <br /> Address fV1 .IJr 2u> .Gi?` iGI7 ..-';f`Z�3� D. <br /> i.icense#. 3 <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:oh0e,Construction Plans,StormwaterPlans w/Silt:Fence installed; <br /> -:Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERCIAL" Attach(2)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,StormWafer Plans w/Silt Fence installed; <br /> Sanitary Facilities&1 dump§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 /> . . . . . : . . . . . . . . . ._. . . . . . .. . . .-_. . . . . <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"$7500) <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 (copy:of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C : :.Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways.;needs ROW, <br />