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<br />Owner's Name G 6 <br /> <br />Owner's Address ,13&)'0 \ ~t:!J. A"r.... ~rh;lb I FL '3 'SS't Z <br />Fee Simple Titleholder Namel <br /> <br /> <br />? <br /> <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br />SUBDIVISION PARCEL ID#I 1 / Z&, Zl oolO '52ob 61gb <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED NEW CONSTR E3 ADD/ALT SIGN D MOVE D DEMOLISH <br /> INSTALL REPAIR <br />PROPOSED USE SFR g] COMM OTHER <br />TYPE OF CONSTRUCTION BLOCK D FRAME STEEL OTHER I <br /> <br /> <br />5'!t!J Aut:- t <br /> <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br /> <br />BUILDING SIZE <br /> <br />1$ t.fO(j-~ I <br /> <br />D ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111111111111111111111111111111'111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111I1111111 <br /> <br />l(1n,jr~,c~;(. I~I I <br />License # I for \50{) \ 1 '12... I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />RJ <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGR~~,," ~ <br />~!. ,l.. ~ of <br />(/~7h ~o~ <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br /> <br />52,~~ <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <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 />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br />I <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 />, <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />License # <br /> <br />COMMERCIAL <br /> <br />~ <br /> <br />111111111111111111111111111111111111111111111111111111II111111111111I11111111111111II11111111111I111111111I11111111111111111111111 <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 wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 wI 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. <br /> <br />Di~~~ti~~~': . . I . . . I I I . . I . I . I I I . . I I I I I I I I I . . . I . I I . I I . I I I I I I I I I I I I I . I . I . I . . . I I I . . . . I . . . . . I I . I . . I . . . . . . . . . . . . I I . . . . I I . . . . . . I . I I . . . . . I I I I . I I . I I . . . . . . . I <br /> <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 (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />