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<br />813-780-00:'W <br /> <br />'-',.., -- --r-~ -J -. ... <br />Building Department <br /> <br />Owner's Name == . <br />OWn.,', Add.." I " '\0 S" f OM<- Q AE'S7' IN IW <br />Fee Simple Titleholder Name _ <br /> <br />F.. Slmpl. TIII.llo.d., Add'." ~ . <br />JOB ADDRESS I (Oct) '- e>AI< ~I1ES:- W4-1 <br />SUBDIVISION 11OA-K &E51 G'51"~l'"'ES I <br /> <br />B <br />D <br />D <br /> <br /> <br />s <br /> <br /> <br />, <br />Owner Phone Number <br /> <br />Owner Phone Nu~ber I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />LOT # <br /> <br />I c:1D <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />~ <br />o <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PARCELlD#lf- oz- 2'- '2.,.' ., Z.30 DoDOO D~c...'O <br />(OBTAINED FROM PROPERTY TAX NOTICE} <br />ADD/ALT 0 SIGN 0 MOVE 0 DEMOLISH <br />REPAIR <br />COMM 0 <br />FRAME 0 <br /> <br />OTHER I <br />STEEL D <br /> <br />WORK PROPOSED <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />. IIi>H Woo <br />SQ FOOTAGE I <br /> <br /> <br />])ES II.IV <br /> <br /> <br />BUILDING SIZE <br /> <br />I <br /> <br />1$)( q.()O. cO <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />DGAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />BUILDING <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />W.RE.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />D <br />I <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />I License # I <br />11(111111111111111111111111111111111111111111111111111111111111111I111111 i III i 111111111111111 i 111111111111111111I1I11111I111 J J 11I1 <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 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 />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 NC <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />1/ NOlYe <br />I Y I N I FEE CURRENT <br /> <br />YIN <br /> <br />BUILDER <br />SIGNATURE <br /> <br />OA-K<!~~~ W~ <br /> <br />License # <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE ClJRRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />YIN <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <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 />OTHER <br />SIGNATURE <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 <br />