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<br />813-780-0020 <br /> <br />lilty or Lepnyrnllls t"ermll I-\fJfJllvClllUl1 <br />Building Department <br /> <br />Date Received <br /> <br /> <br /> <br />Owner's Name ) nO" z.o <br /> <br />Owner's Address 11 ~ LI5 G- e e,Y1 <br />Fee Simple Titleholder Namel <br /> <br />S )0 pe.. <br />, <br /> <br />Dvi V (J <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number l <br /> <br />B <br />D <br />D <br />)\ e \~CJ\A <br /> <br />BUILDING SIZE 2/ j 5 SQ FOOTAGE I /5/ 'J., HEIGHT C <br /> <br />1I1111 I , I1111 I 111111 ' 1111 , ' IITlT"I 11111 11111 IIIIT' 111111 ' , I1I1 . 11111 I ' 11111111 ' 1111 ' , III , , 11111111111111111111111111111111111111 ' 1111111111111111 <br /> <br />I~~/ooc) .GU I <br />D ELECTRICAL 1$ r 6{)O. CU I <br />D PLUMBING 1$ 2!JJ. (j () I <br />D MECHANICAL 1$ / D()() . (;,0 I <br /> <br />I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111I1III11II1111111111I1111111I11I1I111111111111111111111111111111111111I1I1111111II11111111111111111111I11IIIIIIllllllllllillllllllllilllllllll <br /> <br />~t~/hF~~RENT~/N I <br /> <br /> <br />License # I I <br /> <br />I <br />I <br />I <br />I <br />~'~~~~'~~ I ~ ;~:~';:~ IAg!'N me""",,, E2N : <br /> <br /> <br />Address License # <br /> <br />OTHER I COMPANY I <br />SIGNATURE . REGISTERED Y I N FEE CURRENT Y IN <br /> <br />Address I I License # I I <br />111I1111111111I11I111I111111III1111111I11111I11I11111I1111111111111111111111111111111111111111111111111111111 i 111111I111111111111111I1111111111111 <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 onslte, 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 onsite, 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 />111111 ! 1111111111111/1111111111111/11111/1111111111/1111111111/11/1/1/1111/11/1111111111111111111111/1111111111111111111111111111111111/111111111/ <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 cCtltractor) 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 />JOB ADDRESS <br /> <br /> <br />Fee Simple Titleholder Address <br /> <br />SUBDIVISION <br /> <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />D <br /> <br />BUILDING <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />Address <br /> <br /> <br />~~~:~~~E ! <br /> <br /> <br />Address . <br /> <br />~ <br /> <br />I <br />I <br />I <br />~ LOT # 1210 I <br />PARCELlD#13 LI_ 2-5. 21 -0/ 7t.~ -OOOCKJ - 21lrJO I <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D SIGN D MOVE D <br /> <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />OTHER Imob) Ie h6~ <br />STEEL D OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br /> <br />~.~ <br />)f~ <br /> <br />FEE CURRENT <br /> <br />l/DN <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />I ftdt(JiC1cLm I~N <br /> <br /> <br />License # I <br /> <br />~~ <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />Fences (PloUSurvey/Footage) <br />