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Building Department <br /> ate Received J 2 - � <br /> Phone Contact for Permitting <br /> —— <br /> 1 <br /> w nner's-Name t'" L;t+( tl o(Y)C N I 61.0 c. (,L Owner Phone Number <br /> J' <br /> wner's Address LL4,2 S' FG 14-1l bu_t-G' �1 i V��ii f t?(,t� L Owner Phone Number <br /> ?e Simple Titleholder Name Owner Phone Number <br /> Re Simple Titleholder Address" .l AC <br /> JB ADDRESS `! % /��Lv©© s G "�r✓� / 5 ��35 LOT# <br /> UBDIVISION dA;V's O ) PARCEL ID#I I — 6 __O r 0/�Q -,Woo r 0& <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> /ORK PROPOSED e NEW CONSTR 8 ADD/ALT SIGN = DEMOLISH <br /> INSTALL REPAIR <br /> ROPQSED USE ® SFR. 0 COMM C] OTHER <br /> YPE OF CONSTRUCTION BLOCK Q FRAME STEEL Q <br /> ESCRIPTION OF WORK IC LLJ L"C)�) fi (.�G�l SIB —��d'1!L <br /> �UILDING SIZE l_ SQ FOOTAGE HEIGHT <br /> =BUILDING $ f VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ 3,00 AMP Ea SERVICE �;�P/R`OO� GRESS ENEERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> =MECHANICAL $ 1�1 j- VALUATION OF MECHANICAL INSTALLATION <br /> =GAS O ROOFING Q SPECIALTY OTHER <br /> 'INISHED FLOOR ELEVATIONS ) FLOOD ZONE AREA OYES NO <br /> 3UILDER COMPANY <br /> NGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address �O���S% /C �� , �/ierJ�r�,33� License# <br /> ELECTRICIAN COMPANY c ka <br /> RGNATURE REGISTERED Y/ N FEE CURREN LILN <br /> Address License# E� CO 5 ' <br /> PLUMBER COMPANY <br /> SIGNATURE ,N, I REGISTERED Y/ N FEE CURREN YIN <br /> Address 3133/I�� "/.w J/�r/L�IGYif,FL�JL�7�� License# �ga73,177 <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y 1 N FEE CURREN <br /> R/'3 pewttV PV-,, a-5M,FL 3 q(,4a 7 License# 3 2� <br /> "Address <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> lig3i�rv/' e�� Ft,3 " L L/3 5 <br /> Address i License# <br /> nQQaaQ .aneaaaAaaaaaQaQaalfaQ9itiSnaaaaa9910aaaIIaa 09a9a99aa10000a019000 <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 aLife Safety Page;(1)set of Energy Foams.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 />