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<br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Owner Phone Number <br /> <br />~wner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br />,16 Ft.--335'1~ LOT# I (;;0 <br /> <br />PARCEL ID#I3!;:";l.Y d/-iJ /;Z{)- tJoaot1-- 0 bOO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br /> <br />COMM <br />FRAME <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />BUILDING SIZE <br /> <br />D BUILDING <br /> <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />~ <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />f ,Un/)., ~ <br />L.f%tV~JO <br /> <br />D GAS <br />FINISHED FLOOR ELEVATIONS I <br /> <br />ROOFING <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES ~NO <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />IJ[~N tpc!(;, {!'dcdtJj, ~ <br /> <br />License # bc~b9'3~ <br /> <br />I ~1 {f~j am I <br /> <br />License # I f3e.c 13t!tJ 13 ~ 3 <br /> <br />k1~/!#( ~~~fe) ~y <br /> <br />License # IcPe-~ q3?" <br /> <br />Y / N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y / N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Address License # <br />111111I1111I111111I11111I11I111111111I111111I1111111111111111111111111111111111111I111111I1111111111111111111111I1111111I1111111111111111111111111 <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 on site , 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 />i:ii~~~ti~~~': . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . , . . . . . . . . . . . . . . . . . . . , . . . . . . . . , , . . . . . . . . . , . <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 (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />