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<br />813-780-0020
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<br />"'2x-813-780-0021
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<br />PhonE Contact for Purmittin!3 I---~:---J I 1-- r
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<br />Owner P!1i,:me Number
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<br />~~==~] (lv/ller PhiJne Number I
<br />~:===] (lwllel' Phone Number I
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<br />Date Received
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<br />I
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address
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<br />LOT #
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<br />JOB ADDRESS
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<br />DESCRIPTION OF WORK
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<br /> I PARCEL ID#[=~--
<br /> (OEITAINED FROM PROPERTY TAX NOTICE)
<br />NEW CONSTR B ADD/liLT [=:I SIGN D MOVE D DEMOLISH
<br />INSTALL REPAIR
<br />SFR D COMM [=:I OTHER I
<br />BLOCK D FRAME [=:J STEEL D OTHER I
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />SQ FOOTAGE c===~
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<br />HI:IGHT I
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<br />BUILDING SIZE
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<br />D BUILDING 1$ I
<br />D ELECTRICAL 1$ I
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />D GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />C=:J
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<br />PROGRESS ENERGY
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<br />W.R.E.C
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<br />VALUA.TION OF MECHANICAL INSTALLATION
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<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
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<br />DNO
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<br />BUILDER ] GOMPAIIJY [
<br />SIGNATURE FlEGISTERED Y/ N FEE CURRENT
<br />Address ] License #
<br />ELECTRICIAN ] GOMPAltIIY [
<br />SIGNATURE HEGISTEF:ED I Y/ N FEE CURRENT
<br />Address ] License #
<br />PLUMBER ] COMPANY [
<br />SIGNATURE I~EGISTEFtED Y/N FEE CURRENT
<br />Address ] License #
<br />MECHANICAL ] COMPANY [
<br />SIGNATURE REGISTERED Y/ N FEE CURRENT
<br />Address ] License #
<br />OTHER ] COMPANY [
<br />SIGNATURE REGISTERED Y/ N FEE CURRENT
<br />Address ] License #
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<br />Y/N
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<br />Y/N
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<br />Y/N
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<br />Y/N
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<br />Y/N
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<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/largel projects
<br />COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (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.
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<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. (AlC upgrades over $5000)
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<br />Agent (for the cqntractor) 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 roadways..needs ROW
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