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<br />813-780-0020
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<br />Date Received
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<br />Owner's Name n -e Lit- ',e.. e N ~ -A.-- /15 L--L-C..- Owner Phone Number
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<br />0Wne'. Add.... I 3q~ a tMW R.-~$mJ; ~h.Ln" Phone N...b" [
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<br />Fee Simple Titleholder Name M m-f:- Owner Phone Number I
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />335"L{D
<br />:x tf - ;;26 - 02./ - (}660o --00/0()- 61ft {}
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />LOT #
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<br />I ~3
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<br />DEMOLISH
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<br />WORK PROPOSED
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<br />OTHER I
<br />STEEL D
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<br />r:t UJ.-rfoc-l--
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<br />OTHER I
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<br />AMP SERVICE
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<br />PROGRESS ENERGY
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<br />D
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<br />~OL ~
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<br />W-R.E.C,
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Address
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<br />BUILDER
<br />SIGNATURE
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<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
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<br />PLUMBER
<br />SIGNATURE
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<br />Y/N
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<br />FEE CURRENT
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<br />I eft!. /'126 7/g' I
<br />@
<br />I
<br />I
<br />I
<br />
<br />Address
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<br />License #
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<br />MECHANICAL
<br />SIGNATURE
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<br />OTHER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />Address License #
<br />I11II11111111I1111111111111111111I11II11111I11111II111II11111111II11111111111I111111111111111I1111111111111I1111II111111111111I1111111111111111111
<br />RESIDENTIAL 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 />COMMERCIAL
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<br />SIGN PERMIT
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<br />Dl~~~ii~~~': ' . . , , , , . . , , , . . , , , . , . . , , , . . . . , , , . . . , , , . . . . , . . , , , . . , , , . . , , , . . , , , . . . . . , , , , . , , , . . , . . . . . . , , , , . . . . . , , , . , , . . , . . , . , , , , . . , , , , , , , , , , . , , . , , . , . , , . .
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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 NC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadwaysooneeds ROW
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