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.,.. .--- viLy v1 4-c)n iyi 1 una F-V11I m nNNm,auvi i ... .. .... <br /> Building Department <br /> late Received Phone Contact for Permitting <br /> )wner's.Name PiL�ke IO(11L COM )G(.Ilt. LLC, Owner Phone Number <br /> )wner's Address 2Lr(r2 S' FQllCeilb(,trC �/. iJZt�ifP.i,:� L Owner Phone Number <br /> see Simple Titleholder Name Owner Phone Number <br /> 'ee Simple Titleholder Address 0A, <br /> 108ADDRESS ✓U� lZ mil/ s �(/� J J^/J/ 5 y�L/ J o� LOT# <br /> 9USDIVISIO.N OW�S D �S� PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NORK PROPOSED ® NEW CONSTR 8 ADD/ALT SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> 'ROPOSED USE ® SFR. = COMM C] OTHER <br /> YPE OF CONSTRUCTION BLOCK 0 FRAME STEEL /_ <br /> )ESCRIPTION OF WORK <br /> 3UlLDING SIZE SQ FOOTAGE %f HEIGHT <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ 5 3 AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> LO"t Lt,V,-- <br /> =PLUMBING $ / `t� <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING Q SPECIALTY = OTHER <br /> -INISHED FLOOR ELEVATIONS /ADO/,,�/ FLOOD ZONE AREA =YES NO <br /> 3UILDER COMPANY u�Lfc.!!v" 6 <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> � <br /> Address A5, hil n�� 0?l� ;t1n7 r`'3 License# I w a 1,_ 015r <br /> ELECTRICIAN COMPANY 6kudA gla;kl- <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address / � � ` License# EC/2, <br /> � <br /> PLUMBER COMPANY off) / b6 / J <br /> SIGNATURE REGISTERED YIN FEE CURREN <br /> Address 3133di 3 �/GJr�G�� �FG�L�78 J License# /ya'7a-7-7. <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN YIN <br /> R/317�ntGSYI Address fhll� Gt5ty1,FL 3c/(P(a-7 License# 3 Z0 <br /> OTHER COMPANY a l "Coe�79a` <br /> SIGNATURE REGISTERED I Y/ N_J FEE CURREN Y/N <br /> Address �1g31�n//n Dr �J Or?` /c/7 �%Z� 3 License# LL/3� g3-7 <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-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 /> 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 /> 1 � — <br />