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DocuSign Envelope ID:2F9BDBCS-88CE-4EA6-832F-472BCC88E4ED <br /> - .,ILy VI z-cNI lyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permitting <br /> Owner's Name IG A E R Owner Phone Number 813-4a8— 4 7 <br /> Owners Address S3 q 3 ( fb 5T Z14IU-5 Owner Phone Number <br /> Fee Simple Titleholder Name 1 301 WJeWrAgW cORP Owner Phone Number <br /> Fee Simple Titleholder Address I s-sq 3 vo6 5 r 'ZH I f(-e5 <br /> JOB ADDRESS S 3 Me-o-DOWOOp 7,Ep(4 HIWS rL 33S LOT# 7� <br /> SUBDIVISION P9SADowop a7,q7V PARCELID# /3-a6-9/-6/y0 -00000 -07ao <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED ® NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE XQ SFR = COMM = OTHER <br /> TYPE OF CONSTRUCTION ® BLOCK ® FRAME = STEEL = <br /> DESCRIPTION OF WORK NEW 51t461,E/1,AMl[,Y KomE <br /> BUILDING SIZE 36' X S"9 SO FOOTAGE /89� HEIGHT 1 IO t 6 r <br /> ©BUILDING $/[r/O 000 1 VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL IS <br /> S 000 AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> QPLUMBING $ 71 V Od �V I ���Pl"" <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> 7 000 0 1(' <br /> =GAS E] ROOFING = SPECIALTY `.J OTHER �� U <br /> FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA =YES NO <br /> BUILDER s COMPANY COKP <br /> SIGNATURE / / REGISTERED N FEE CURREN I WN <br /> Address License#I CPLC /73,2 <br /> — ocusgne y: EAST PAS CO ELECTRIC, INC. <br /> ELECTRICIAN COMPANY <br /> SIGNATURE• REGISTERED I Y/ N FEE CURREN I Y/N <br /> Address ANTHONY LEGER EC-13003069 <br /> License# <br /> --'Docusl0ned bY: <br /> PLUMBER COMPANY SANTbS PL,,M13/NG r L( .— <br /> SIGNATURE i Q��t�^•v J�^"iW�S REGISTERED Y/ N FEE CURREN N <br /> r—GihG GtK <br /> Address I License III Cfc1428843 <br /> MECHANICAL cccu 'ene r• COMPANY SOSA AIR FLOW, INC �^ <br /> SIGNATURE J au Soso REGISTERED I Y/ N FEE CURREN <br /> Address License# CAC1819615 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN I Y/N <br /> Address License# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <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 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 Fortes.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 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 /> Dlrectrons: <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 Attomey(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 />