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<br />813-780-0020 <br /> <br />Lilty or Lepnyrnlll5 t"'errrlll f'\[J [J1Il;cHIU I I <br />Building Department <br /> <br />Date Received <br /> <br /> <br /> <br />I <br />I <br />I <br />LOT# I~t 7 I <br />PARCELlD# I 34 .2.5 - 2 /.. 0 170 - 000 00 .. 2170 I <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 />(j I <br /> <br />Owner'sAddress 17{tJ45 Gr'e.en 510D e PyiVf <br />I <br />Fee Simple Titleholder Namel <br /> <br />Owner's Name <br /> <br />Fee Simple Titleholder Address <br /> <br />31 <br />G <br /> <br />o NEW CONSTR r=J <br />GZI INSTALL D <br /> <br />PROPOSED USE D SFR D <br />TYPE OF CONSTRUCTION D BLOCK D <br /> <br />DESCRIPTION OF WORK I mob i\e.. nome... set-LAp <br /> <br />BUILDING SIZE 12/ X 5 q I SQ FOOTAGE 115 q 3 HEIGHT I <br />111111 I II 111111 11111 " 111111111 1111111111111111111 ' , 111I1I1111 .. 1111111111 . 1111 " 11111 II " " II " . 1111111111111 " 111111111111 ' 111111111 111111111111 <br /> <br />1$ 35000.00 <br /> <br />1$ t 5 CO. 00 <br /> <br />1$ 260.00 <br /> <br />1$ J ,500.0 () <br /> <br />o GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />1~~1t~~eJC~REt^H{ Y/N I <br /> <br /> <br />License # I I <br /> <br />I <br />I <br />I <br />I <br />~I~:~I~:,-I~ ;:'0':.':: Lf{Lf, N FEEeu..,,,, V/N I <br /> <br /> <br />Address i License # I <br /> <br />OTHER I COMPANY I <br />SIGNATURE . REGISTERED Y I N FEE CURRENT Y I N <br /> <br />Address I License # I <br />11111II11111111111I11I111111111111111111111111111111111III1I1111I1111111111111111111111111111111111111111111111111111111111111111111I1111111111111 <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 ail NEW construction. <br />II,IIII! II" 1111111111111111111111111111111111111111111111111" II"" 11111" 1111111111111111111111111111" 11111111111111111111111111111111111111" I <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 />SUBDIVISION <br /> <br /> <br />JOB ADDRESS <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 />OTHER I mObilL ho~ ~ <br />STEEL D OTHER I <br /> <br />o <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 />WR.E,C. <br /> <br />o <br />o <br /> <br />PLUMBING <br /> <br />o <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br /> <br />LA (. t <br />I Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />!~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />I ~u~ff(;/re!/!c/3EN~J <br /> <br /> <br />License # I <br /> <br />Address <br /> <br />Y/N <br /> <br />Address <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 />