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<br />813-780-002U <br /> <br />"-II'J _. --...... oJ' - p- . - <br />Building Department <br /> <br /> <br />J <br /> <br />, <br />OWner phone Number <br /> <br />OWner PhOn. Nn~'" ~ <br />Owner phone .Nu~ber <br /> <br />Owner's Nam <br /> <br />owner's Address [ <br /> <br />Fee Simple Titleholder Name[ <br /> <br /> <br />ot I z.D <br /> <br />Date Received <br /> <br />Fee Simple Titleholder Address I <br /> <br />r S"9/;, 5 <br />I <br /> <br />0~11 <br /> <br />tf/vD <br />1 <br />,B <br />o <br />o <br /> <br />1 LOT # <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br /> <br />I r//lE" ;C,{(,,{ (S"S .1",;( J <br />o OTHER <br /> <br />WORK PROPOSED <br /> <br />DESCRIPTION OF WORK / / .It v ~ . rl/ ..r;.., <br /> <br /> <br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I - " , ' ," " " .. " ,'..., " , " " "" ."" ' " <br />1I1I I , II , 111\1111111 III ' I , 1111 , I . , I ' III , 111111 , III , III , 11111111 ; 1111111111111111111111111111111111111111111 <br /> <br />D BUILDING '1$ it DO, c:::>O 1 <br /> <br />D ELECTRICAL 1$ 1 <br /> <br />D PLUMBING 1$ I <br /> <br />o MECHANICAL 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 />11111111111111111111111111111111111111111111111111I1111I11I1I11I1I1111111111111111111111111111I111111I1111111II111111I1111111111II11111I11111I11111 <br /> <br />BUILDER I I COMPANY I ' I <br />SIGNATURE REGISTERED I Y I N FEE CURRENT Y I N <br /> <br />. Add".. i . I u"",. · I <br /> <br />I <br />I <br />: <br />: <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br />1:t <br /> <br />, PROGRESS ENERGY <br />S-tooO' <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />COMPANY <br />REGISTERED <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />YI N <br /> <br />FEE CLJRRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Address <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 /> <br />License # <br /> <br />Address <br /> <br />~~t'-f (/If I fi/( C 4!;"s.. Cd <br />~ I@ N. I FEE CURRENT I Y I N I <br /> <br />License # lJS"~ " ~)(J()aJ I tJ 9 S I <br /> <br />OTHER <br />SIGNATURE <br /> <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 />COMMERCIAL 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 />SIGN PERMIT 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, 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 Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />