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813-780-0020 Fax-813-78U-UU:ll Date Received Fee Simple Titleholder Nam Owner Phone Number ner Phone Number I Owner Phone Number I Owner's Name . Owner's Address Fee Simple Titleholder Address JOB ADDRESS SUBDIVISION D D D D r=-v1 NEW CONSTR [:=J ADD/ALT D tj INSTALL c:J REPAIR PROPOSED USE D SFR D COMM D OTHER TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D DESCRlPTIONOFWORK I P(op~Y-reeh rOom/ ~1il1j'+o/ 6hed_ BUILDING SIZE I _ SQ FOOTAGE I L/'flf ~ _ HEIGHT I 9 I ...11......11..111......11.11..11...11.11.11...11......111...............11...11...11.....11........111........11...111...1111..11.11.........1111 1$1;c217~ I 1$ I 1$ I 1$ 1 D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I 1 FLOOD ZONE AREA DYES ~NO ,.."""".""""",.",."." :..",.", ,.", ,.., ,.",.. .~.'" "~''(j:O'''''' .,",.,":"",. ""., ",., ':':""'.."" ."" ~.,.. """",. BUILDER I ,)!" COMPANY I / ~-P--k II-km1flapt(#C I SIGNATURE ~ REGISTERED ~ I I FEE CURRENT ICV b N Jt: License # I eRe 05"$'5/7 I I I I I I I I I WORK PROPOSED SIGN D DEMOLISH OTHER I BUILDING VALUATION OF TOTAL CONSTRUCTION ELECTRICAL AMP SERVICE ~ PROGRESS ENERGY 1JDC / \-.\-e.. ~l/Y"r- ~~ D W.R.E.C. PLUMBING MECHANICAL VALUATION OF MECHANICAL INSTALLATION Address COMPANY REGISTEREO El eCTRICIAN SIGNATURE YI N FEE CURRENT Y/N Address License # PLUMBER SIGNATURE COMPANY REGISTERED Y I N FEE CURRENT Y/N Address License # COMPANY REGISTEREO MECHANICAL SIGNATURE Y I N FEE CURRENT Y/N Address License # OTHER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # 1III I I II11II . .. I 11111111 I 1111111111 I , n I I 11111 I 1111 . III " , . n I . . 11111111111111111111 n I " I . 1111111111111111111 " I 1 r 1111111111111111111111 III1IIII RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. 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 . l I I ~ I I I I I I I I I I I I I I I I .J . 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 Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (AlC 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 (PloUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW