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<br />813-780-0020 <br /> <br /> <br />Fax-813-780-0021 <br /> <br />Date Receiyed <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />ADDIALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />I <br />I <br /> <br />339fO LOT' I lib \ <br />a 'f -- :1 b'- :2f -- /)IJ tfo -0 tJOlJd- /h50 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />o SIGN D MOVE 0 <br /> <br />o <br />o <br /> <br />~hf <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />B <br />o <br />o <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />SQFOOTAGE 63/.;)5 <br /> <br />D BUILDING 1$ 3'1) ooo.=~~d:'~ IONOFTOTALCONSTRUCTION <br /> <br />D ELECTRICAL 1$ I ~ j5 SERVICE D PROGRESS ENERGY <br /> <br />~ OU <br />D PLUMBING 1$ 13~('d' <br /> <br />D MECHANICAL 1$ I ~)VALUATION OF MECHANICAL INSTALLATION <br /> <br />D GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ~O <br /> <br />I111I11111111111111111111111111111III111111111111111111111111111111111111111111111111111111111I1111111111111IIIII!IIIIIIIIIIIII~IIIIIIIIIIIIIIII <br /> <br />:~~~~RE i~~ I ~~~~R: I ~~~-Ifk,EEAjf.!:(fJ'f~r~' I <br /> <br /> <br />Address License # I I <br /> <br /> <br />~t:;;~~N! fJ~ I ~~~= f7Y1~nle!:;-!!:/2 rDN I <br /> <br /> <br />Address . License # I I <br /> <br /> <br />~t~:"~~~E ! ri1tu4!~ I ;~::~~ C1Pr; ~ 18N I <br />~~I <br />I <br /> <br />BUILDING SIZE <br /> <br />p6 <br /> <br />W.R.E.C. <br /> <br />NOe. - ~ <br /> <br />Address <br /> <br />MECHANICAL ! <br />SIGNATURE . <br /> <br />Address <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I License # <br />1111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111 <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 wI 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 wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projecls. All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Di~~~t;~~~':' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <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 AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />