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<br />813-780-0020 <br /> <br />liny or Lepnyrnllls r--emlll1-\\J\JIIl,;i:1l1UII <br />Building Department <br /> <br />Date Received <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br /> <br />Owner's Address I {~L/ 5 <br />Fee Simple Titleholder Namel <br /> <br />s/()P~ Drlve <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />131~D Gill Ave <br />ICrtil10 J-/a n'lan <br />. <br /> <br />o <br /> <br />, <br /> <br /> <br />0/ NEW CONSTR r=J <br />G INSTALL D <br /> <br />PROPOSED USE D SFR D <br />TYPE OF CONSTRUCTION D BLOCK D <br /> <br />DESCRIPTION OF WORK I rvJObi I ~ homc- .s [f - LI.~ <br /> <br />BUILDING SIZE \. 21 X5 0 I SQ FOOTAGE /5 / . I HEIGHT I I <br />TfTTITT' , 1111I ' III . . IIIIIIIIIIIIII~ , 111111111111111\11111111 , . II . III , . 1I11 . 1111 . 1111111111 . III . 1111111 " 1111 , 111111111111 ' II . \111 . . 1111 ' 1111111 . II <br /> <br />1$~5lDo. 0 () I <br />1$ l ()(x::>.o 0 I <br />1$ 2JQ.oc> I <br />1$ /500. 60 I <br /> <br />o GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 ill 11111 III 11111 I11I1 11111 III II <br /> <br />:~~~~~RE I~--" ;~~::.: @5f/r~~HJ I~ I <br /> <br /> <br />Address i~~ License # I I <br /> <br />ELECTRICIAN ~--______ COMPANY I~ L- I@I <br />SIGNATURE =============~~ REGISTERED C'!J N I FEE CURRENT ._ <br /> <br />Address . License # I I <br /> <br /> <br />:~:A~~~E ~ ;~~~':: I f3tffff:f{1 tj+ I@N,' <br /> <br /> <br />Address _ ~ License # . <br /> <br />MECHANICAL~. _ COMPANY 17t1 <br />SIGNATURE = RE",m'EO '-I g;N FEE 00""'"' IlV~ <br /> <br />Address License # I <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 />1I111111111111111111I1111111111111I11111111111111111111111111111I111111111111111111111111I111I111I11111111111I1111111111111111111111I11111111111I1 <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 onsite, 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 />1I1111 ! 111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 f 111111111111111111111111111111111111 <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 NC <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />I LOTi I 217 <br />PARCELlD#13'-1-25 -21 -()J76-0000()- 27 Ie) <br />(OST AINED FROM PROPERTY TAX NOTICE) <br />D SIGN D MOVE D <br /> <br />~ <br />D <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />OTHER I rYJISyfU / hLJI'YLt.J <br />STEEL D OTHER I <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E,C, <br /> <br />o <br /> <br />o <br /> <br />o <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />