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VI Ly V1 Z-VP1 1y111111J r G111 nL nNNm,auvl l ,�^ •�-•��-���, <br /> Building Department <br /> late Received <br /> Phone Contact for Permittin <br /> rr rr r-e e�-i-C71717 <br /> )wner's Name P�LI�t � D(1�L CD IVY A.1)t. I✓�G Owner Phone Number <br /> )wner`s Address 2bU2 S' Fa-l4nbu!� 0/ iJer�'f L Owner Phone Number <br /> 'ee Simple Titleholder Name / Owner Phone Number <br /> 'ee Simple Titleholder Address I A <br /> IOB ADDRESS ( �82� ( ODGr�S �e/ !'����5� G 3 LOT# <br /> IN <br /> >UBDIVISION 01v%S0 M00 PARCEL ID# (/! a�Ll' -Al 0/;Z0 -D 30L <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NORK PROPOSED M <br /> NEW CONSTR R <br /> ADD/ALT l� SIGN = DEMOLISH <br /> INSTALL REPAIR <br /> IROPOSED USE ® SFR 0 COMM [ OTHER <br /> TYPE OF CONSTRUCTION 1 BLOCK 0 FRAME t^_J STEEL = <br /> )ESCRIPTION OF WORK >7 GV "(/n fi^uG�i n lCGLr`Y1 r l <br /> 3UILDING:SIZE � �PLTSQFOOTAGE�' <br /> HEIGHT 1 =- <br /> BUILDING $ Dd VALUATION OF TOTAL CONSTRUCTION <br /> .=ELECTRICAL $� , AMP SERVICE = PRPR-OGRESS ENEERGY W.R.E.C. <br /> (L� ► ✓� �✓LL� Ln�r l,. <br /> =PLUMBING $ <br /> =MECHANICAL $ ` ///i/� ,� VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING 0 SPECIALTY = OTHER <br /> =INISHED FLOOR ELEVATIONS 6?1,3 /^ / FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE ,/ REGISTERED Y/ N FEE CURREN/}/1 Y//N_ <br /> Address ����5� n6 r� ;VN1e,ofrt+3�� ` License# tZia(Y a5- <br /> ELECTRICIAN COMPANY cJkGdA <br /> SIGNATURE y REGISTERED Y/ N FEE CURREN Y/ <br /> !� N <br /> Address / / , �/ ` License# ?e<�J <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREK <br /> Address : 3133��3 r ��Gvr/�IGYY�,Fl,3 78� License# C e,l ya_7a_7 <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> �h11� d5La1,FL 3 eP(v License# 3 2� <br /> Address / <br /> OTHER COMPANY �"L A"CA�79�`G <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> /Ig3� iv/n IJr Di?` icl7 1=Z,3 <br /> Address i License# <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 />