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Date Received Fax-813-780-0021 8'13-780-0020 la- \<6.0 Owner'sName We. rne.. (2. ~ Owner'sAddress I b/30 /1-11t ;5~er, ZetJhyrh/f/s Fee Simple Titleholder Namel 1111.....11 Owner Phone Number 33t..2-own" Phone Numhe, I Owner Phone Number I Fee Simple Titleholder Address I I b /30 /7 f-It SfreeJ- I LOT# I cJ.5 I (Jar!:' Hill I PARCELlD#lo~-d0-;</-OIJ'GJ-OOOOO-0250 (OBTAINED FROM PROPERTY TAX NOTICE) D NEWCONSTR r=J ADD/ALT D SIGN 0 MOVE D D INSTALL D REPAIR PROPOSED USE D SFR D COMM D OTHER TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL 0 DESCRIPTION OF WORK IAdcL glass uJt'hdou/S fo e 'f.ishf1J Op€A'L porch 1 X J) r; I SQ FOOTAGE I J. 0 g l/J I HEIGHT 1 11111111111TlIIIIIIIIIIII' 11111111111111111111111111111111111'" 1111111111111111111' 1111111111' 111111' 'II" I" 111111111" P 11111111111111111" 11111 1$ 54-SO, ~ D ELECTRICAL 1$ D PLUMBING 1$ D MECHANICAL 1$ D GAS D FINISHED FLOOR ELEVATIONS I JOB ADDRESS SUBDIVISION WORK PROPOSED DEMOLISH OTHER I BUILDING SIZE D ROOFING I I I I D I AMP SERVICE ~ PROGRESS ENERGY D W.R.E.C, BUILDING VALUATION OF TOTAL CONSTRUCTION f..J 0 c VALUATION OF MECHANICAL INSTALLATION SPECIALTY D FLOOD ZONE AREA OTHER DYES ~NO BUILDER SIGNATURE ELECTRICIAN SIGNATURE Ree~ I Y I N I Baht S ffI UA?7 (>1-WfYl. .~c b N I FEE CURRENT cJ::'?)' N I License # I C8C OcJ...,bO 11 E~c.- I Y/N I License # lEe.. /300 J 35""3 FEE CURRENT Address Address PLUMBER SIGNATURE COMPANY REGISTERED Y I N FEE CURRENT Y/N Address License # MECHANICAL SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # OTHER SIGNATURE COMPANY REGISTERED Y I N FEE CURRENT Y/N Address 111111111111111 RESIDENTIAL License # 1111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Stormwater Plans wI Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects Attach (3) sets of Building Plans; (1) set of Energy Forms, R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects, All commercial requirements must meet compliance Attach (2) sets of Engineered Plans, ....PROPERTY SURVEY required for all NEW construction. COMMERCIAL SIGN PERMIT Dl~~~ti~~~': I I I I I . . I I . . I I I I I I I I I I I I I I . I . I . . . I I I . I I I I I I I . I I . . . . I . . I I I . . I I I I I . . I . . . I I I . . I I I I I . I . ~ I . . . I I . I I . I . . . . . . . I . . I I . . . I I I I I I I I . I I I I I I I I I I I I I I I I I Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A1C upgrades over $5000) Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades NC Fences (PloVSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW