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<br />813-780-002U
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<br />"""I"J "". --r..J"....
<br />Building Department
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<br />/Date Received
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<br />/..4 8A.e
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<br />,
<br />Owner Phone Number
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<br />Owner Phone Nu~ber i
<br />Owner Phone Number i
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<br />"I' Owner's Name -..: A ,. J C 5' c: .
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<br />/ Owner's Address I ~Zll. /.II;e./t:. S7,
<br />Fee Simple Titleholder Namel
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<br />Fee Slmpl. Till.holde, Add.... i
<br />r b 2...1 2.. l."t} /l. ~
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<br />/ JOB ADDRESS
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<br />sr
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<br />OAKS/bE. mo8i/t!E I~e Mi.f- LOT# r
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />B
<br />o
<br />o
<br />
<br />NEW CONSTR
<br />INSTALL
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<br />SFR
<br />BLOCK
<br />
<br />PARCELID#I O~-Ol<.:,-~d.\ ; OOd-.D . 01)?:>(5D - Obl6
<br />(OBTAINED FROM PROPERTY TAX NOTICEI
<br />ADD/All 0 SIGN D MOVE 0 DEMOLISH
<br />REPAIR
<br />COMM 0
<br />FRAME 0
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />1
<br />
<br />
<br />.8
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<br />I I 0 ~ 5''' X fs::,o' j) ,IL i 1/ l:. t..h9 f
<br />/ DESCRIPTION OF WORK I'
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<br />BUILDING SIZE 1 1 SQ FOOTAGE !/ ! . -"EIGIfT ,1,.",,,,,,,,,,,,,,,,,.1..,,,,,,,,,,,,,,,,,,, "
<br />IIII 111 II , III " II ' II , I , I , 1I11 I I I ' III 1111111 , I11I1 " " I "1111111 1111" 1111111111111111 I" III " " III I
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />OTHER I
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<br />1
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<br />VALUATION OF TOTAL CONSTRUCTION
<br />o ' PROGRESS ENERGY
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<br />AMP SERVICE
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<br />W.R.E.C.
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<br />,cI BUILDING '1$ Z/tJ{). If'C
<br /> -
<br />0 ELECTRICAL 1$
<br />0 PLUMBING 1$
<br />0 MECHANICAL 1$
<br />0 GAS 0 ROOFING
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
<br />
<br />DNO
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<br />Address
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<br />/
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />License #
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<br />/' BUILDER
<br />SIGNATURE
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<br />SIGN PERMIT
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<br />Address I I License # I I
<br />111111111111I11I11111111111111I111I111111111111111I11111111111111111111111111111111111111 i III i 11111111111111111111111111111111111111 i 111I11II1111I
<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 onslte, 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 />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111I111111111I1111111111
<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 />,j,. Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter fro~ oWner authorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service UP9rades NC
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />FEE ClJRRENT
<br />
<br />Y/N
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<br />License #
<br />
<br />Address
<br />
<br />PLUMBER
<br />StGNA TURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N I.
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<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 />YI 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
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<br />COMMERCIAL
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<br />Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
<br />lack's Oakside Mobile Park
<br />38539 Crescent Ave.
<br />i;'c",h"rhills, FL 33542-283.
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