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<br />813-780-0020 <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address I Sa",n e., <br /> <br />I 3~1 ?vri~lk rr.ft4/I~ Pi-- 335'fO I LOT' 1.3// <br />I ~ lyv./d il2 o PARCEL 10#/ t;lJf-~-dl-t:Jt)%()- tftJ:J1lJ- 3J;0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />EJ NEW CONSTR rvi @D)ALT D SIGN D MOVE D <br />INSTALL t=1 REPAIR <br />PROPOSED USE D SFR D COMM D <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D <br /> <br />DESCRIPTION OF WORK I !-()..;ha i r;f.- sC.reen rOOm <br /> <br />SQFOOTAGEI oo~tP <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />HEIGHT <br /> <br />~ <br /> <br />...."...'111.....,..111..'-'...,.."'......1111..............111.............11...1............11111.........'11'11.....1111111111...11111111111. <br /> <br />BUILDING <br /> <br /> <br /> <br />I <br />I <br />I <br />D <br />I <br /> <br />D <br />J'711~Co V~ <br /> <br />PROGRESS ENERGY <br /> <br />~ <br /> <br />W,R.E.C. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />D GAS <br />FINISHED FLOOR ELEVATIONS I <br /> <br />ROOFING <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES )z:JNO <br /> <br />.~ <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />PLUMBER <br />SIGNATURE <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />/I 14f1.~ -=:.~ <br />a./ aJ tle.r OJ. <br />I Y / N' FEE CURRENT Y / N <br /> <br />License # I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />I 42 C2/ .~~ <br />'LI) (JP ~ -:7:?l.-' <br />Y /"N.I FEE CURRENT I Y / N <br /> <br />License # I <br />n ~ - ~,.. <br />j"" If~/?-rr:E CURRENT"> -- I Y / N <br /> <br />License # I <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 />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 /> <br />License # <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111I11 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R-O-W Penn it for new construction, <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction, <br />Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Stonnwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects, All commercial requirements must meet compliance <br />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />""PROPERTY SURVEY required for all NEW construction. <br />11I111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />