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<br />813-780-0020 <br /> <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br />Fee Simple TitleholdQr Name <br /> <br />Owner Phone Number 8/0 -::7lU:'70w:J2I <br />. y:<Pwner Phone Number I <br />Owner Phone Number I <br /> <br />- Owner's Name <br /> <br />=' Owner's Address <br /> <br />Fee Simple Titleholder Address <br /> <br />WORK PROPOSED <br /> <br />b rnct{s <br />PARCELlD#lm-d(C -d-I-CX)/{)-~-- DQJO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE 0 <br /> <br />LOT # <br /> <br />-' JOB ADDRESS <br /> <br />- SUBDIVISION <br /> <br />D NEW CONSTR [=:J ADD/ALT 0 <br />~ INSTALL D REPAIR <br />PROPOSED USE 0 SFR 0 COMM 0 <br />- TYPE OF CONSTRUCTION ~ BLOCK D FRAME 0 <br /> <br />DESCRIPTION OF WORK I (fJs-!CJllnew 'f!J/fertDr" door <br /> <br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT <br /> <br />"...11....11...111..'.1........,.........1111....11.............11....111....11.'.........1111..11,...........1.11................................ <br /> <br />1$ IdOO ~ <br />1$ <br />1$ <br />1$ <br />o <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />GAS <br /> <br />ROOFING <br /> <br />I <br />I <br />I ~ k~ ~dWner <br /> <br />!-. VALUATION OF MECHANICAL INSTALUlTION ~e..~/f- spiV <br /> <br />L-J OTHER 'V \Jd-~ <br />DYES <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C <br /> <br />-'3] <br /> <br />o <br />o <br />o <br />o <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />DNO <br /> <br />- BUILDER <br />SIGNATURE <br /> <br /> License # <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 /> License # <br /> <br />Y/N <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />OTHER <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />1111I1111111111 11111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111I1111111111111111 <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) complete sets of Building Plans plus a Life Safety Page; (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 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 />I1111111111111111111I1111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I <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 (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />