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<br />813-780-0020 <br /> <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br />Fee Simple Titleholder Name <br /> <br />~hone pmber <br /> <br />W Owner p~e Nu~er I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I Same: ~5 a0() v<2- <br /> <br />:3/ff~i Ie- ~'1Is. Ii- 335'k! <br />tin frJ /1:;' PARCELlD#I.;?f-:oZh-c2I-tlt78"o-OOOa1-;L1cUJ <br />Ef (OBTAINED FROM PROPERTY TAX NOTICE) <br />NEW CONSTR r=J ADD/ALT D SIGN D MOVE D DEMOLISH <br />INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM D <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D <br /> <br />DESCRIPTION OF WORK I ~rrJer1J..1 d. flJ j n-IG !-rLn i -.J- 5 if -een. r D&--rn <br /> <br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I <br />1111'11111111111111111111111"1111111111'1111111111111111'1111111111111111111'1'1111111'1111111""'11111'1111"11111"1111'1111111111111111111111 <br /> <br />LOT # <br /> <br />l;zq~ <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />1$ 5ooo,~ I <br /> <br />D ELECTRICAL 1$ I <br /> <br /> <br />D PLUMBING 1$ I <br /> <br /> <br />D MECHANICAL 1$ I <br /> <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ~O <br /> <br />111111111111111111111111111111111111111111111111111111IIIIIIIIIIIII~IIII)IBIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111111111(1111111111111111111111111 <br /> <br />BUILDER I . Q I , JCOMPANY I OtUnetf - I <br />SIGNATURE C) REGISTERED I Y / N FEE CURRENT I Y / N <br /> <br />License # I /} ! tZ.. <br /> <br />D <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />~ <br />?osIL P-pp~~ / <br />NoC- ~ <br /> <br />WR.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />I DK/Jer <br />Y / N I <br /> <br />FEE CURRENT <br /> <br />I Y/N <br /> <br />I {J!~ <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />I {)(i!r1~~ <br /> <br />FEE CURRENT <br /> <br />I Y /N <br />11/~ <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address License # <br /> <br />111111111(11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111(11111111111111I1111111111111111111111111111111 <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 onsile, Construction Plans, Stormwater Plans w/ 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~~~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 <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 AlC Fences (Plol/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />