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<br />813-780-00lU <br /> <br />"-.III.J _. __r-~.J'.u- .- <br />Building Department <br /> <br />/ Owner's Name <br /> <br />/ Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />s~\ (':~~ <br /> <br /> <br />j <br />Owner Phone Number <br /> <br /> <br />Owner Phone Nu~ber I <br /> <br />Owner Phone Number I <br /> <br />/ Date Received <br /> <br />U>-~ e.. <br /> <br />Fee Simple Titleholder Address I <br /> <br />1-3 '6 CoD ~ <br />1{\\(Mc. \i\ \\c1 CA 0 <br />~ <br />B <br /> <br />PROPOSED USE D <br /> <br />TYPE OF CONSTRUCTION D <br /> <br /> <br />./ DESCRIPTION OF WORK I CX'D.\" \\ C\\<.... ~Y"\Ce- <br /> <br /> <br />BUILDING SIZE I . I SQ fo'oT AGE I \ 9::> ! HEIGHT 1 ,,,,,..,,,..,,,.,,,,, I" .. " , .. . "'" " , " , " <br />II II Jill 1 II1II , I , . III I I II , I , I I II III 1 , I , II , 111 , ,. III 111111111111111111 , 1111111111111111 111111111111111 <br /> <br />1$ ~ 5" 0 I <br /> <br />o ELECTRICAL 1$ I <br /> <br />o PLUMBING 1$ I <br /> <br />o MECHANICAL 1$ I <br /> <br />o GAS D ROOFING 0 SPECIALTY 0 OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I. . I FLOOD ZONE AREA DYES DNO . . .' <br /> <br />1111111111111111111111111111111111111111111111.11111111Illllllllllllllllllillllllllllllllllllllllllllllllllll11111111111111111111II1111111111111111 <br /> <br />. BUILDER ~ ' . _ COMPANY II h6~o.,.){\.e/ . I <br />/ SIGNATURE '=.,,- _ _ ~ REGISTERED I Y I N I FEE tuRRENT Y IN <br /> <br />Address 2B~ _~ A0€- License # I I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />I License # I I <br /> <br />1111111111111111111111111111111111111111I11111111111111111111111111111111I111II11I11111111111II1111111111I111111111111111111111111 <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns . <br />Minimum ten (10) working days after submittal date. Required onsUe, Construction Plans, Sanitary Facilities & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Fonns. <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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />Directions: . <br />Fill out application completelY. <br />Owner & Contractor sign back of application, nolarized <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 Ale <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />Co..~~ ~e.... <br />E~~w-4 <br />E3 <br />o <br />o <br /> <br />J <br /> <br />LOT # <br /> <br />/ JOB ADDRESS <br /> <br />. SUBDIVISION <br /> <br />PARCEL ID# I <br /> <br />3S" - 26- 2\ -DOC) ~ - 60000 ~ 1,3 a <br />(OST AINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />o <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />/0 <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />, PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CLJRRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <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 />MECHANICAL <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 />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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />