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Building Uepartment <br /> ate Received <br /> v Phone Contact for Permitting Z "r <br /> 1wner's Name r'+�.��C U(1'�C l��'�.)(•l.11 [.(- Owner Phone Number <br /> lwnees Address �4�2 S, FGL ftjt] <br /> Owner Phone Number <br /> ee Simple Titleholder Name / Owner Phone Number <br /> ee Simple Titleholder Address ./A <br /> OBADDRESS 1(J -IV 9Jft�1!/l Ifo� `J4t�Q Vt 'IrY6�,l5 3J�-I& LOT# � <br /> ,UBDIVISION 00,v6 PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> PORK PROPOSED e NEW CONSTR 8 ADD/ALT SIGN Q DEMOLISH <br /> INSTALL REPAIR <br /> 'ROPOSED USE ® SFR 0 COMM = OTHER <br /> YPE OF CONSTRUCTION J I `BLOCK �0 FRAME STEEL = <br /> )ESCRIPTION OF WORK <br /> SQ FOOTAGE `1(J 1 HEIGHT f .:l 2 r� -I, <br /> BUILDING•SIZE <br /> =BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ �r,�jy l AMP SERVICE PROGRESS ENERGY 0 W.R.E.C. <br /> =PLUMBING Is �sk=00 <br /> • =MECHANICAL $ /„ D,Dv VALUATION OF MECHANICAL INSTALLATION <br /> L <br /> =GAS Q ROOFING Q SPECIALTY = OTHER <br /> =1NISHED FLOOR ELEVATIONS I FLOOD ZONE AREA =YES NO <br /> pa"OdAt(, Ile— <br /> BUILDERA_V/ COMPANY <br /> SIGNATURE rr REGISTERED Y/ N FEE CURREN�} Y/N <br /> Address ��,),r� r� r /eC!>f�L,3 License# <br /> ELECTRICIAN /Ul COMPANY 5vu .gzeG l y l G <br /> SIGNATURE REGISTERED Y/ N FEE CURREP LKLN <br /> _,let ba 1 la t e'_Vaj a/Y�42 t r <br /> Address License# E� �� <br /> PLUMBER COMPANY 0M 64 l !)OM <br /> SIGNATURE REGISTERED YIN I FEE CURREK <br /> Address 313 3/i/�3 / ,FG 3735 License# Ll C �a 7 a <br /> MECHANICAL COMPANY =/0414S 'IrY <br /> SIGNATURE REGISTERED Y/ N . FEE CURF Y N <br /> R/3 /7GrL Y1 Address GtSGyI,FL 341Z,&­71 License# � /? taa5Z�OTHER COMPANY Aa /�� <br /> G`1" I Vew a` <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> J <br /> Address /q /7/In l�r (i "i FL, 3y License# <br /> oeeoea .eee � Qeanaa0aeeltea >FAe � [ d � so � � � oilEeaa � � tsAtliBBOII � fI1C0As0etauue <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 subdivisions/large projects <br /> COMMERCIAL- Attach(2)complete sets of Building Plans plus a.Life Safety Page;(1)set of Energy Forms.R 0-W Permit for new construction. <br /> Minimum ten-(10)working days after-submittal date. Required onsite,Construction Plans,Stormwater Plans wl 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 /> 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 />