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813-7BU-UU:'W vllY VI L.t::fJl IY' I 11110 I 011111' "1-'1-'""'......"'" Building Department Per Ok; +- Se~ Vl- (.L.../ Date Received Owner's Name Y\ Ma.t..l. i~ Owner's Address I (q LfO 3 La.LArel r....>ooc:L Dr. Fee Simple Titleholder NamJ 6a...1u-L- Fee Simple Titleholder Address I sa.-- Owner Phone Number I OWner Phone Nu~b~r I LaLl.re-L,.000~ D. ) Zepl.1'trh;(le,/ Fl. 33S-L{?-- I LOT # I . PARCEL ID#I 0'3-;L(p - ;;1../- OlGfO - 00000 - 003A (OST AINED FROM PROPERTY TAX NOTICE) D NEWCONSTR ~' ADD/ALT D SIGN D MOVE 0 D INSTALL Cl REPAIR PROPOSED USE ~ SFR 0 COMM D OTHER TYPE OF CONSTRUCTION D BLOCK ~ FRAME D STEEL D OTHER I c:1 uVk(""i~ DESCRIPTION OF WORK I E nc 1 o.se.. ex.lstl~':j L-tz~l \ a...V\.t:t Add. s.cv-ee-LL QroI'\A-..- BUILDING SIZE I~~~~= \~;~~ I SQFOOTAGEI ~~~ ~ I HEIGHT I se<:... p1~,:> . I I . I . I . I I . . I I I . I . I I . . . I . I I I . I I I . . . I I . I I I I I . I I I I . . I I I I . ~ . . . I . oJ . I . . I . I . I I I . I I I . I . I . . . I . I I . I . . I I I I . . I I . . I I . . . I I I I I I I . I I I I . I . I I I I . I I I . I I I . I I I I I I I . I I . SUBDIVISION (PL{o3 S i Ive.r Oa.-ks 3ft JOB ADDRESS WORK PROPOSED DEMOLIsH I I. I ~ BUILDING 1$ IS, 7'3~. 50 o ELECTRICAL 1$ o PLUMBING 1$ o MECHANICAL 1$ o GAS 0 FINISHED FLOOR ELEVATIONS I VALUATION OF TOTAL CONSTRUCTION AMP SERVICE t=J PROGRESS ENERGY D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION ~O(, ----- ROOFING D I SPECIALTY 0 FLOOD ZONE AREA OTHER DYES DNO I I I . I I I I I I I I I I I , , , I I I I I I I . I I I I I . I I I I I I , I I I I I I . . I I I . . . . I . I . I . I . I . I . I , I I I I I . . , II . I I I I I . . I I , I . , . ~ . I I . . I I . I I I I . . I . I I . I I . . I . I I I I I I P I I I I I I I . I I . I I I I , I I I I Address I~Jtu~ 0t..lLfD ft, K," ~'-<-~ SS/9 tHt/1 COMPANY REGISTERED I ~@'N I B~r's Al~",,"~u..>--"l:J.X-'r-C r N I FEE CURRENT I. D N I Uc~nse # Ie l3C- b 'd-.CeD 77 cluJ. ~~ellu.' I PLUMBER SIGNATURE YI N FEE CURRENT Y/N ~ I .~ I I I ~ I I I ~ Rd., ~ ''15_,;)7- IJ/I/d z--AtJ/I fl, .]Jsr/ I I. COMPANY . REGISTERED fio ).':Y~ COMPANY REGISTERED BUILDER SIGNATURE ELECTRICIAN SIGNATURE FEE CURRENT I~/N Address License # '1;~~ 2-It-/k 11. 3JJf/ I I Address License # MECHANICAL SIGNATURE w4~~ '/Yl.// A/U/l ~u1 ~E~:~~~~ I L3~~ . I~O~~':uRREf:j +1 ~ Address License # OTHER SIGNATURE COMPANY REGISTERED YI N FEE CURRENT Y/N Address License # 111'1111'111111'111111'111111.1'11'1'1'11"11'1""1.'11.111."1.1'.1.1.1,.11.1,.,.1.1'1..1.1.1.1'.1111'.1111I"I"IIIIII'I'li'IIIII,.ill'II'III'II' RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster Attach (3) sets of Building Plans; (1) liet of Energy Forms. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for ari NEW construction. . III1IIII1IIIII111111111111111111111111 ~ ~ . II . & 1111. I . I 11.11111 . . I i ~ II IIIII1 ~ IIII i I II II i III i i i i III I i II i I II . i I i I II I I i I i I i I I i II . i i I I ~ i I j Ii." i i i i j Iii Iii i . Directions: Fill Qut appllcallon completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same . . OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AlC COMMERCIAL SIGN PERMIT Driveways Fences (PloUSurvey/Footage)