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<br />813-780-0020
<br />
<br />VILI VI ~'"'t'''J.'''''- . -""
<br />Building Department
<br />
<br />Date Received'
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<br />
<br />'/- I Y
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Name
<br />
<br />Fee Simple Titleholder Address
<br />I '7 0- "3 "
<br />I
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />\-\ ~, CS"n \ ~ (\CJ L()
<br />I PARCEL ID#I
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<br />
<br />LOT #
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<br />JOB ADDRESS
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />B
<br />o
<br />D
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />3Y - ~5-:l\ -,6\60. OOCDO-03'30
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />DEMOLISH,
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<br />SUBDIVISION
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<br />DESCRIPTION OF WORK I Tn ~ C L (10 R . ~ ~~ (u..:> cx::::D ') ,
<br />
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<br />. 1$ I
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<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />o GAS 0 ROOFING 0 SPECIALTY 0 OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS I. I FLOOD ZONE AREA DYES DNO .
<br />
<br />111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111I1111
<br />
<br />COMPANY I t-\-~61...L.~ I
<br />REGISTERED I Y I N I FEE CURRENT Y I N
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<br />I License # I I
<br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111'111I111111I1111111I11111
<br />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 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 />11.1111'1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades Ale
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />o
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />License #
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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