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<br />813-780-0020 <br /> <br />{.;ity or Lepnyrnllls t-'ermlt AppliCatiOn <br />Building Department <br /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Slmpl. TII,.hoIO.. AOO.... I tY.-1 A I q <br />153sd.'~ 1>t, . LOT # <br /> <br />PARCEL 10#1 ~ - ;)J" <,;{ 1,(Q04-O ( O([)If()O' O()q D <br />iOBTAINED FROM PROPERTY.TAX NOTICE) <br />NEW CONST D ADD/AL T D SIGN D MOVE D DEMOLISH <br />INSTALL ~ REPAIR <br />SFR r--J COMM D OTHER <br />PROPOSED USE D L....J D <br />O. BLOCK r--J FRAME D STEEL . <br />TYPE OF CONSTRUCTION L....J <br /> <br />I ()~ ""'/.0. I Q s;~ /SiL<<, <br />DESCR'PT'DN OF WORK ~ n "'- _ _ DO At I <br /> <br />BUILDING SIZE I I sa FOOTAGE I '" " ,,! "" ~~~ "I" . .. " " " " " , . , " "" "."" " "" " . , . ,. , <br /> <br />QQ"'" ~~,~~;~~"""'" ,."';~',:' 44-" ~" i"'" ~~~~~~~'~~ TOTAL CONSTRUCT'ON <br /> <br />D 1$ I AMP SERVICE 0 PROGRESS ENERGY <br />ELECTRICAL . . <br /> <br />o PLUMBING 1$. I <br /> <br />o MECHANICAL 1$ I <br /> <br />o GAS D ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES. <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br />Address IIf:f~Te..tlsOn PI. <br />ELECTRICIAN I AlJ;+ <br />SIGNATURE . <br />Address I <br /> <br />:~~~~E I rJ / fr <br /> <br /> <br />Address ~ <br /> <br />MECHANICAL I 1J/ J1 <br />SIGNATURE. ;-+- <br /> <br />Address ! <br />OTHER · 7 <br /> <br />s~:::e (,'~~~ <br /> <br /> <br />~~~~~i.~he, <br /> <br />Oda..hdo ( FL. '0 ~ ~I.;l. I License # /( <br /> <br />I COMPANY <br />REGISTERED <br /> <br /> <br /> <br />FEE CURRENT <br /> <br />I <br />I <br />: <br />I <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br /> License # <br />Y/ N FEE CURRENT I Y/N <br /> License # <br />Y/N FEE CURRENT Y/N I <br /> License # <br />Y/N I FEE CURRENT r Y1N <br /> License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />I <br />COMPT <br />REGISTERED <br /> <br />RESIDENTIAL <br /> <br />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 onslte, Construction Plans, Stormwater Plans wI Slit Fence Installed, <br />Sanitary Factllties & 1 dumpster; Slle Work Permit for subdlvlslonsllarge projects <br />Attach (3) sets of Building Plans; (1) set of Enl;lrgy Forms. R-O-W Permit 'for new construction. <br />Minimum ten (10) WOrking days after submittal date. Required onslle, Construction Plans, Stormwater Plans w/ Slit Fence Installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />COMMERCIAL. <br /> <br />SIGN PERMIT <br /> <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 AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />