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<br />813-780-0020 <br /> <br />vlty or Lepnyrnllls t-'ermlt AppliCatiOn <br />Building Department <br /> <br />rdA.-O IJ-/OU-UU~ I <br /> <br />Date Received <br /> <br /> <br /> <br />() <br />Owner'sAddress I jf.t;4 {) areeY1 <&/DP.j)V <br /> <br /> <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br /> <br />PARCEL 10#1 <br /> <br />I <br />I <br />I <br />LOT # I 251- I <br />~'7~Z5 -2) -D/7D -COOOC)~ 2~~ <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Fee Simple Titleholder Address I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />Address ~81.!> 6 13/4 ff,. <br /> <br />~1~~~~:Lr=~ .-' <br /> <br /> <br />Address __ <br /> <br />OTHER I <br />SIGNATURE <br /> <br />M~I ~~# <br />111111111111111111 " I1I1I11111111111111111111111111111 " " " 1I11I " III " 11111111111111 " Ii" I " " 111111 " " II " 1111111 " II " 111111111 1111111111 " I <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Sanitary Facilities & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />'**~PROPERTY SURVEY required for all NEW construction. <br />111111111 " I " 11I111111111111111111 " " I " I " 1111 " I " 11111111111111111111 " " I " I " II " I " " 11111111 " 1 " 1111111111 " II " 11111111 " III " 111111111 <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. (AlC upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />c=1 NEW CONSTR [:=J <br />[j2J INSTALL D <br /> <br />PROPOSED USE D SFR [:=J <br /> <br />TYPE OF CONSTRUCTION D BLOCK D <br /> <br />DESCRIPTION OF WORK I 'N\Dbi \ -L '" ()V\1 e S e.+ -L-tp <br /> <br />BUILDING SIZE I JLj t Jj 2- I SQ FOOTAGE I J 2 '-I 8 HEIGHT I <br />III I 11111 II I I , I I11111 , . I I I 1111 I III I I , , 111111 . , . , II . , 11111111 11111111 , . , I . , .. " II1111 " 1111 .. 1111111111111111 " I " 11I1 . . 111111 1111111111 11111111111 <br /> <br />1$ 1~, 000. OC> I <br /> <br />1$ L 060. 0 0 I <br /> <br />D PLUMBING 1$ J!){X).. 00 I <br /> <br />D MECHANICAL 1$ it 5'00. bC& I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />111I11111111111111111111111111111111111I111111111111I11111111111I111111111111111111111111111111111111II111111IIIIIIIIIIIIIIIIillllllllllilllllllll <br /> <br />~~:~~~ ~tf~~'N' ~] I <br /> <br /> <br />License # I I <br /> <br />I <br />I <br />I <br />I <br />I <br />, I <br />I <br />I <br /> <br />OTHER <br />STEEL <br /> <br />I fYbk::'i lLho Yl\ ~ <br />D OTHER I <br /> <br />D <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />..0-.. W.RE.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br /> <br />ELECTRICIAN!~ ~ <br />SIGNATURE <br />Address <br /> <br />:~:::: !~~~~ <br />~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />11& <br /> <br />FEE CURRENT <br /> <br />e Y/N <br /> <br />License # I <br /> <br />~~~fr ~~~REJ;,\ l1~ IN <br /> <br /> <br />License # I <br /> <br />PLUMBER <br />SIGNATURE <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />~~ <br /> <br />FEE CURRENT <br /> <br />lay IN <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />