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<br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner'S Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />. QA-UI.'" I.':'':' ....u~., <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 />ri7l NEW CONSTR El ADD/AL T D <br />D INSTALL REPAIR <br />PROPOSED USE 0 SFR 0 COMM 0 OTHER <br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME 0 STEEL 0 <br /> <br />DESCRIPTION OF WORK I eo ncreJ-e- 6/ a_ h <j- rO!!J h In P /:tl f1 q <br /> <br />BUILDING SIZE I I SQ FOOTAGE I I ~EIGHT _ V <br /> <br />.......111......11.........'..'1,...11.11'.......11...111.111...,.....".111...'..11......111.11111"...'11.1111.1.,.IIIIIIIII..IIIIIII...I.I'p1.1 <br /> <br />1$ ,~$.QQ o~ <br /> <br />/ <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />o GAS 0 <br />FINISHED FLOOR ELEVATIONS I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />\Xl <br />D <br />l8J <br />o <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />SPECIALTY D <br /> <br />FLOOD ZONE AREA <br /> <br />SIGN <br /> <br />D <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />BUILDING <br /> <br />PLUMBING <br /> <br />D <br /> <br />~ <br />~ne./I <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />MECHANICAL <br /> <br />ROOFING <br /> <br />OTHER <br />DYES <br /> <br />~O <br /> <br />1111'11111'11"'1""'11'111"'111,111"'11111"'1111'"111"""1"'."'1"111'1111'1'111",11""""11111t,,'I""I,'I"III,I"I"1111111111111 <br />-V <br />BUILDER (g <t l COMPANY <br />SIGNATURE REGISTERED <br /> <br />Address <br /> <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br /> <br />License # <br /> <br />Y/ N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 onslte, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects <br />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTy SURVEY required for all NEW construction. <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I i III i 1111111111111111111111 <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Commencement is required. lAIC 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 (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways 00 needs ROW <br />