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<br />I T <br />~U;~N~~E;~~m;:3~L:TH ~~,~e~~Y~~l~:~~;;~~ /tJ;1 /os- <br /> <br />813-780-0020 FAX: 813-780-0021 ~ '>7 ~~ <br />DATE RECEIVED ,/ '0(" 'V\J <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME 1J?~~qL-t-tJV&2-- II- <br />JOB ADDRESS ~..Ee:t~ 1\S"/LvE/f <br />//::2 <br />PARCEL ID * pI..3~6d?-/d/.;;<#ootJ/J /102~ <br /> <br />~EA/IJ.A- PHONE <br />cJ,&J-k .LJ~/VF. <br /> <br />cP/..3 :75"~ =?dt?~ <br /> <br />LEGAL DESCRIPTION: LOT($) <br /> <br />SUBDIVISION \9LI/E"f' <br /> <br />c:::1 ~A<r <br /> <br />BLOCK <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />o SIGN <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMI!LY DWELLING <br /> <br />o COMMERC*L <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0* OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />t:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF won #~C;/N~ ,e-K~te-I(/A::.. -LJr/&tf\J...... <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2)! PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3)1 SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2~ SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY S\J'RVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />1t tf ~qi <br /> <br />0 BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br />0 ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />0 PLUMBING <br />o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />o GAS o ROOFING o SPEdIALTY 0 OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BiLoCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br />SIGNATURE <br /> <br /> <br />I <br />CCJMPANY\../1 rF-C~PEII/T7< f; /A/C. <br /> <br />STATE CERT OR REGIST # C? (.";t:t? ;;:{;;2<f'-.a / <br /> <br />I!lUILDER <br /> <br />ll:LECTRICIAN <br /> <br />...-: .;~ <br />5L. <br /> <br />.*********.****************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST * <br /> <br />************~***************************************.************* <br /> <br />PLtlM8l!:R <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />Mll:CHANICAL <br /> <br />i <br />*************i****************************************************+ <br />! <br /> <br />STATE CERT OR REGIST * <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST * <br /> <br />************ **************************************************** <br /> <br />OTHER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST * <br /> <br />-----~._- <br />