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Building Department <br /> de Received Phone Contact for Permitting q� , ) t� -- 15 6'2— <br /> wner's Name i t �< < U 111 C Lii.'(d� )((.Il c. L-L Owner Phone Number <br /> S, Falk�llbur ` I ►v��rrter,� <br /> Nner's Address / Owner Phone Number <br /> m Simple Titleholder Name /r` Owner Phone Number <br /> ;e Simple Titleholder Address I A <br /> JB ADDRESS (sU / /, GL� �i� fS�� �J I%1/� 64 <br /> LOT <br /> UBDIVISION (�,� VM0 P PARCEL ID# v (� !'�� � Q 301 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> IORK PROPOSED e NEW CONSTR 8 ADD/ALT SIGN Q DEMOLISH <br /> INSTALL REPAIR <br /> ROPO,SED USE ® SFR. 0 COMM OTHER <br /> YPE OF CONSTRUCTION ] II BLOCK [] FRAME STEEL <br /> ESCRIPTION OF WORK <br /> ,UILDING SIZE SQ FOOTAGE HEIGHT <br /> BUILDING $ , n�� VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ J �� AMP SERVICE Q PROGRESS ENERGY Q - W.R.E.C. <br /> =PLUMBING is <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING Q SPECIALTY = OTHER <br /> 'INISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA =YES NO <br /> 3UILDER. COMPANY tl C (G(�'�►`i(— (_ <br /> HGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address pt/ v,5,Aa /16�q: , R, License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N 77 FEE CURREN L11 N <br /> ij -<A ! 11 CIS7ylal, `7/yal Q/yT I- �I <br /> Address / License <br /> PLUMBER COMPANY. <br /> 31GNATURE REGISTERED YIN FEE CURREr, Y/N <br /> Address 1313,3/�� 37� 01/GJ(�GlIC�Y /,FL-3 -79 J`� License# �( yZt 7 �(-71 <br /> MECHANICAL' COMPANY �I��T�S '/'Y C /(/Dyll ��/Q <br /> SIGNATURE REGISTERED Y I N. FEE CURRENn Y I N <br /> Address <br /> R/_3 i7GrLtQYJ AtJf� �SLal,FL 3q(P(v-7 License# da%! l /2 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED YIN FEE CURREN Y/N Address I fi93141_V/n Or eG) O/'1� /G/7 ")al License#. L 613-�?15 93 2 <br /> �➢ B ➢ eex..➢ ® AA99 ➢ ➢ ee ➢ e ➢ 1@e ➢ lESA ➢ Ei1 ➢ 0eIleil ➢ it ➢ Bee ➢ ➢ ➢ ➢ ealla ➢ e ➢ ➢ lsfl ➢ ilr ➢ e ➢ ole0O6 <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/811CFence 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 />