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<br />1313-780-0020 <br /> <br /> <br />Fax-813-780-0021 <br /> <br />Date Rect~ived <br /> <br />1111......11 <br /> <br />Owner's Name <br /> <br />Owner Phone Number <br /> <br />~~hone Number I <br /> <br />Owner Phone Number I <br /> <br />I <br />I <br />I <br />FL33 LOTN II? I <br />- ~6 -c2-/~ 001 r!- -6oo(J() -0 I 2(D <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <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 />I <br />I <br />I <br />I <br />I <br /> <br /> <br />Address License # I <br /> <br />MECHANICAL I COMPANY I <br />SIGNATURE REGISTERED Y / N FEE CURRENT Y I N <br /> <br />~~I ~~# I <br /> <br />OTHER I COMPANY I <br />SIGNATURE . REGISTERED Y / N FEE CURRENT Y I N <br /> <br />Address I License # I I <br />11111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111IIII11111111I1111 <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 onsite, 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 onsite, 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades NC <br /> <br />D <br /> <br />D OTHER <br /> <br />D STEEL D <br /> <br />()h eyisnrrq ~<<:r <br /> <br />BUILDING SIZE SQ FOOTAGE I .-J _ HEIGHT I <br />111111111111"'" P' 1111111111,'" 1111'1111111"'" 1111111; I) '\J 1111111111111111'" '11111111111111111' I'" 111111111111111' 1111' 111111111111111111111 <br /> <br />D BUILDING :$ 3M6ot> 1.t VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELECTRICAL $ ~ ] AMP SERVICE r;L6 PROGRESS ENERGY D W.R.E.C <br /> <br />D PLUMBING 1$ I i\Joc - (2...C& <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ~NO <br /> <br />11111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111I11I11111111111111 <br /> <br />:~~~~~RE ;~;= 15~~El(~/I7~~)~ <br />3 ~:2. License # I c K.~b~!7 <br /> <br />COMPANY I <br />REGISTERED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />WORK PROPOSED <br /> <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I 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 />