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<br />I I <br />tnJ-ftlu-UUfU <br /> <br />vllY UI L..~~IIYIIIIII;:) ,vIIlIILf""\PP",",ULIVII <br />Building Department <br /> <br /> <br />I LOT# I <br /> <br />PARCELID#I~4-;l~-dl-OOOO-OOIOO-~O <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE D <br /> <br />Date Received <br /> <br />Owner's Address <br /> <br />Fee Simple Titlehol <br /> <br />Fee Simple Tltlehol er Address I <br /> <br />13<6rJ b /...aC/)~fe..- 8f. <br /> <br />I~e she- O~ts /(e5i)r t I <br /> <br />Iil NEW CONSTR E3 <br />D INSTALL <br />0Cl SFR D <br />D BLOCK rLJ <br />I shed T CarO{)rT <br />, <br />1),.5/'1381 SQFOOTAGEI <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />PROPOSED USE <br />TYPE OF CONSTR <br /> <br />DESCRIPTION OF <br /> <br /> <br />'-f15 tfJ <br /> <br />BUILDING SIZE <br /> <br />Owner Phone Number 813 - 780- <br />2- Owner Phone Number I <br />Owner Phone Number I <br /> <br />tiff <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />~ <br /> <br />OTHER I ~ <br /> <br />HEIGHT I <br /> <br />D BUILDING 1$1300. g;.. I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRI AL 1$ 1 AMP SERVICE D PROGRESS ENERGY D W.R.E.C. <br /> ~7~ <br />D 1$ I 11/;' K 47'] c/ ,J 0 c- ---- <br />D 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR E EVATIONS 1 I FLOOD ZONE AREA DYES DNO <br /> <br />/lZ, 5" COMPANY Is@ S-fak AIIWI/I1~ <br />REGISTERED Y 1 N I FEE CURRENT / N I <br /> <br />rhills -t..3 lf2-- License # lese 1~;)418'3 <br /> <br />I <br /> <br /> Y / N FEE CURRENT <br /> License # <br /> Y/ N FEE CURRENT <br /> License # <br /> Y/ N FEE CURRENT <br /> License # <br />COMPANY <br />REGISTERED Y/ N FEE CURRENT <br /> License # <br /> <br />ttach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br />Inlmum ten (10) working days after submittal date. Required onslle, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />anltary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br />ttach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction. <br />Inimum ten (10) working days after submittal date. Required onsile, Construction Plans, Stormwater Plans w/ Silt Fence Installed, <br />anitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />ttach (2) sets of Engineered Plans. <br />".PROPERTY SURVEY required for all NEW construction. <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br /> <br />Directions: <br />Fill out appllcatio completely. <br />Owner & Contra tor sign back of application, notarized <br />If over $2500, a otlce of Commencement Is required. (AlC upgrades over $5000) <br /> <br />Agent (for the co tractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTE PERMITTING (Front of Application Only) <br />Reroofs ewers Service Upgrades AlC Fences (PloVSurvey/Footage) <br /> <br />Driveways-Not ver Counter if on public roadways..needs ROW <br />