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... '~...�" [%tvof Zeoh�rh\UG Permit Application Fax-813-780-0021 <br /> BuUdingDbpartnnn <br /> Date Rec6ived F Phone Contact for Permitting <br /> Owner Phone Number <br /> Owner's Name <br /> Owner's Address Owner Phone Number <br /> -Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> E5 INSTALL E REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME STEEL E� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> =BUILDING VALUATION OFTOTAL CONSTRUCTION <br /> =ELECrRCAL AMP SERVICE �--\ PROGRESS ENERGY �--1 VVJR.E/� <br /> w)7 <br /> =pLU| <br /> �--l��CH�Nk�AL MECHANICAL <br /> ^--� VALUATION —�� <br /> ^ <br /> =G^S L�� Fn]OpNm F—� � SPECIALTY OTHER <br /> OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA F--lYEa NO <br /> - - - - - - - - - - - - - - - - - - - - - - - <br /> BU|LDER COMPANY " Ln,c <br /> SIGNATURE REGISTERED L_l�_�_] 'seoun«E^ L_l /NL_| <br /> AddressUconno# <br /> ELECTRIC COMPANY [::�r1p Eler:�) <br /> SIGNATURE REGISTERED L_I I N_J psEounnsu L_�L�_� <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE esGmrEnso [_y/_w_ E u YINL� ^� <br /> Address u #. <br /> MECHANICAL COMPANY <br /> SIGNATURE , L��1��_] FeEnunnex _ff����_| <br /> AddressNe-W1. 3 License# <br /> OTHER ���P/g�Y <br /> SIGNATUREnso/STsReo [_y!�i_� �Eounnsx [ h,N �� <br /> ' <br /> 4ddmaa Licnnoe# <br /> RESIDENTIAL Attach(2)Plot P\unb|(2)sets of Building Plans;(1)set of Energy Forms;R-O4m Permit for new construction, <br /> Minimum ten(1O)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> SanitaryFad8beo81dumpstocGheVYodkPennitforaubdiWsions/|a0epngocts <br /> COMMERCIAL AMauh(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O4w Permit for new 'constrxcUon. <br /> Minimum ten(1O)working days after submittal date. Required onaUe.Construction Plans,Gtormvater Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must,me6t compliance <br /> SIGN PERMIT sets of Engineered P|ana. <br /> ""~"PROPER[Y SURVEY required for all NEW cunntrucUun. ' <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over s25on,a Notice mf Commencement isrequired. (A/C upgrades over*75VV) <br /> � Agent(for the contractor)ur Power ofAttome�(for the owner)would be someone with notarized letter from owner authohzinQsame <br /> OyERTHE COUNTER PERMITTING (copy opyofnonbactmquined) <br /> Ramofs\fshingles Sewers Service Upgrades A/C Femcem(P{oKSumey/Footoge') ` <br /> Driveways-Not over Counter ifon public madvayo.00udoROW <br /> ` <br /> ' <br />