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<br />813-780-002U """"J ..... --.....J..-- <br />Building Department <br /> <br />IIIIII.IIL.I <br /> <br /> <br /> <br /> <br />, c.,/I. <br />Owner Phone Number - <br />1$I$"6c9 y ,,' I <br />Owner Phone Number <br /> <br />I Owner Phone Nu~ber I <br /> <br />Date Received' to. "'-\ - 0 <br /> <br />5cC\ I en ~ <br />Owner's Address II "?:> J ~ ro Potolc1o eX: Dr. Chard l>>t (5'1-/ <br />Fee Simplel Titleholder Namel <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />13<6\3\ ~ ~nnc.A- <br />Ie ha ~ IL'<;'1lYn. 0 A 1< c:;. <br /> <br />I- 0 -\-- <6 <br /> <br />LOT # <br /> <br />a <br /> <br />I PARCELID#lo~~ d b~<1/-0~~~tJooOO~OO &0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />~ NEW CONSTR D ADD/ALT 0 SIGN 0 MOVE 0 DEMOLISH <br />D INSTALL . D REPAIR <br />PROPOSED USE gj SFR 0 COMM 0 OTHER <br />TYPE OF CONSTRUCTION ~ BLOCK 0 FRAME 0 STEEL 0 OTHER I <br /> <br />DESCRIPTION OF WORK I AJ e. LV S. \'\..~ I e ~ n'\ \ \.. l' !?es ,"01 eM S<!- , <br /> <br />BUILDING SIZE IS~'.x 5F"'f// I SQFOOTAGEI ~ 0~ I) I HE~GHT I /~ 1~/1 ItApS;to.;~ (e.f;~ <br />1111 III , II II I I I II , III , 1 , 111111111 , II , 1I11 11111 , , 1111111 1111111111111111111111111111111 ; 1111111111111 11111 , II , II 1111111111 1111111111111111111111111 <br />D BUILDING ' ~ '/f/ ~ I <br /> <br />D , ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I <br /> <br />D GAS 0 ROOFING 0 SPECIALTY 0 ' OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111111111111111111111111111111111,,1111111111I111111111111111111111111111111111111111111111111111111111I11111111111111I1I1I11I111111I11 <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />';)..o-e; <br />AMP SERVICE <br /> <br />823 <br /> <br />, PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />~CJ..,W - <br /> <br />(Jl' \ 0o.J...k. <br /> <br />~:? oq cD <br /> <br />: i <br /> <br />. \ "t . <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />OOd' <br /> <br />I~~,<, ~~\"''''<.,~ . <br />~ N I . FEE CURRENT Y N I <br />License # ~ ~'- \ (,J ~~<;'ctJ;:::, <br /> <br />,f}jffiS FEEC~~ IQN I I <br />License # I (j ",,&J f'3 f 'I rf I <br />I <br /> <br /> <br />Address I License # I I <br /> <br />1111111111111111111111111I1111111111111111111111111111111I1111111111111111111111111111111I1111111II11111111111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date. Required onslte. Construction Plans. Sanitary Facilities & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Forms. ,," <br />Minimum ten (10) working days after submittal date. Required onslle, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance. . <br />Attach (2) sets of Engineered Plans. <br />"'~PROPERTY SURVEY required for all NEW construction. <br />~1~~~U~~~~ J 1111111 J 1111111111111111111111 J J 11111I J II Jill Jill J J 111111111111111 J 1111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />Fill oul 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 <br /> <br />Addre,ss <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANIGAL <br />SIGNATUR:E <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />t.-/4L.f1 <br /> <br />.A//<A/ <br /> <br />f?Q <br /> <br />'2- ',I.'I/t <br /> <br />I <br /> <br />.3...3;-. <br /> <br />OTHER <br />SIGNATUR.E <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />