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813-780-0020 Cit , ills Permit Application Fax-813-780-0021 <br /> Buildin apartment //]�� ,`m <br /> Date Received �J y✓�(K�/sY/ <br /> Pho Contact for P rmitting (J�3 - ✓��Y `/ <br /> Owner's Name �/�� / �e OwnerPh one Number 3sa <br /> Owner's Addres U itn i 4�` �-1 S Owner Phone Number <br /> Fee Simple T) eholder Name Owner Phone Number <br /> Fee Simple Title older Address <br /> JOB ADDRESS u/J�7/[7!t/tom I�t /f L� �s �L3 7 LOT# <br /> SUBDIVISION Q le— PARCEL ID#Q3_o)(I d 017 d '00AX) — PS-0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR e ADD/ALT = SIGN Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION BLOCK/�0 FRAME = STEEL = <br /> DESCRIPTION OF WORK V Creep 2d&, B h a eu-cJ [,& l C <br /> BUILDING SIZE 9y�oL � SQ FOOTAGE® HEIGHT <br /> Tf��rTF�Pr�A"'r�P'Pr'�1'RT1T1'S'9"(�i�'9�r'7STf'�7'R9"1TP'ITET�fTPi®1"�IT�i PT�i ��T'P" <br /> QBUILDING $/ 0 0 6 VALU ATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ 1� /!MECHANICAL � <br /> TlJ <br /> $ VALUATION OF MECHANICAL <br /> NICAL INSTALLATION VyA <br /> VC/ <br /> =GAS = ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO r� <br /> BUILDER• •� •COMPANY��(,(((S!<• �ul�t/h G[K/L <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN I Y/N a mot/ 1 <br /> Address c 24 i it rK d— License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURA REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address I License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111I1I11I111111i11111 <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,Stornwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsAarge 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,Storrnwater Plans w/Slit Fence Installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance v <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> +1-d-1—I•-1®F-1+I+D+!—&-"- —1+1I+Lmt+l-4-I+i®I+E+1—f+4-0-d9�{--1—l+l�l+l+lml+l+1� <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. (AIC 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 />