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<br />813-780-0020
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<br />Fax-813-780-0021
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<br />Date Received
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<br />Owner's Name
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<br />Owner's Address I 5 d- 0 I
<br />Fee Simple Titleholder Namel
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<br />JOB ADDRESS
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<br />,h,'!(s PL- 3d5Lf1- LOT# 11;~ I
<br />PARCELlD#111 - J..b- cJ./ - 0010 -- I g'f{Jt) - ooLfO I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />S+re..ef; l.ephyr-h,"/ls 3~5"lfAvner Phone Number I
<br />I Owner Phone Number I
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<br />Fee Simple Titleholder Address
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />NEW CONSTR
<br />INSTALL
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<br />SFR
<br />BLOCK
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<br />D
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<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
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<br />DEMOLISH
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<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />DESCRIPTION OF WORK LRe - r- 0 of-
<br />BUILDING SIZE I I SQ FOOTAGE I HEIGHT I
<br />111"""1111111111111111111""'111111""""""1""'11111111111'111""1111111111111111'1'1""11111111111111111"'1111111111111111111"11111
<br />D BUILDING 1$ Gf5 ~~, C!!2. I VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D
<br />D PLUMBING 1$ I ~OC/
<br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ~NO
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<br />111111111I111I111111111I11111111111111111111I111II1111IIIIIIIIIIIII~~~'J..!.!IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111,1111111111111111111111111
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<br />:~~~~~RE otWzd ;= I ~~~FEE~~m~1 I
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<br />License # I eRe. Osgs/ 7 I
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<br />OTHER
<br />STEEL
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<br />OTHER I
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<br />W.R.E.C,
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<br />Address
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<br />COMPANY
<br />REGISTERED
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />Y / N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />License #
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
<br />
<br />Address
<br />
<br />License #
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<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
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<br />License #
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<br />1111111111111111111I1111111111111I111I11111111II1111111111I11111111111II1111I1111111I1111111111I11111111I11I1111111111111111111111
<br />Attach (2) Plot Plans; (2) 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 onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />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 onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
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<br />DI~~~ti~~~': ' , , , , . , , , , , , , , , , , , . , , , , , , , , , . , . , , , , , , , , . , , , , , , , , , , , , , , , , , , . , , , , . . , , , , . , , , , , , , , , , , , , , , . , , , , , , , , , , . , , , , , , , . , , . , , , . , , . . . , , . . . , . . , , , . . , . , , ,
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<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)
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<br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage)
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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