|
<br />813-780-0020
<br />
<br />Fax-813-780-0021
<br />
<br />Owner's Name
<br />
<br />
<br />Owner Phone Number
<br />
<br />ote~~umber I
<br />
<br />
<br />Owner Phone Number I
<br />
<br />Date Receive,d
<br />
<br />Owner's Address
<br />
<br />WORK PROPOSED
<br />
<br />3 kr
<br />I Td5a Medrif 1)-15 ~
<br />
<br />
<br />D NEW CONSTR ~
<br />D INSTALL tj
<br />
<br />PROPOSED USE D SFR D
<br />
<br />TYPE OF CONSTRUCTION D BLOCK D
<br />
<br />LOT # c;;(
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />SIGN
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />
<br />;;;;~~~ I~" ,,~~,~ ,',p" ~~~; r~~,t" ",!, " , ~~:~~~, .I.. " " " " " " "" , " ,I" " " " " " " " " " " ,
<br />
<br />1$ 7oLfq~
<br />
<br />1$
<br />
<br />1$
<br />
<br />1$
<br />c=J GAS D
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />ROOFING
<br />
<br />I
<br />I
<br />I
<br />I
<br />D
<br />I
<br />
<br />AMP SERVICE
<br />
<br />oQ
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />~VQ ~~
<br />~~ r-
<br />94NO
<br />
<br />W,R,E.C,
<br />
<br />c=J
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />c=J
<br />c=J
<br />
<br />ELECTRICAL
<br />
<br />PLUMBING
<br />
<br />c=J
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />OTHER
<br />DYES
<br />
<br />Address
<br />
<br />~~ 4LtIf::'['~/fG
<br />License # le8C.~ t, 677
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address License #
<br />
<br />1111111111111I1111111111111I11111111111111111111111111I111111111I111111111111111111111111111111I11111111111111111111111111111111111111111111111111
<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/large 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 wI 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 />
<br />Di~~~t;~~~': ' , . , , , , , , , , , , , , , , , , , , , , , . , , . , , , , , , . , . , , , . , , . , , , , , , , . , , , , , , , , . . , , , , , , , , , , . , , , . , , , , , , , , , , , , . , , , . , , , , , , . . , , , . . , , , . . , , , , , , , , , , , , , , . , , , . . , , .
<br />
<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 Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|