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<br />Owner's Name V e rl:L Go I d <br />Owner's Address l39 t.f 3 ~ q +k A vrz. ' <br />Fee Simple Titleholder Namel .5a..\M.L- <br /> <br /> <br />Fee Simple Titleholder Address I 6a..~ <br /> <br /> <br /> <br />I <br />1 <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number i <br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />13C1tf'3le q-+~ Ave, <br />ISI-U'15e.:r e s+a.+~~ <br /> <br />JOB ADDRESS <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />J <br /> <br />~ <br />o <br />o <br />Roo rv\ <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br /> <br />o <br />o <br />CD VI CI e.-- TG <br /> <br />DEMOLISH <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />OTHER <br />STEEL <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />AMP SERVICE ~ ^kROGRESS ENERGY <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DJEC <br />roc) <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />DYES <br /> <br />~NO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />Address <br /> <br />1../ q ;;J.(~ ftJ'r orf Rd. I Z e h <br /> <br />335'1 :;{ <br /> <br />License # <br /> <br />ELECTRICIAN I <br />SIGNATURE j. <br /> <br />Address . <br /> <br />PLUMBER I <br />SIGNATURE i <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br />OTHER j. <br /> <br /> <br />SIGNATURE . <br /> <br />Address I License # <br />11I111111111111111111111111111111111111111111111111111111111111111111111,11111111111111111111111111111111111111I1111111111I11111111111111111111111 <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 />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 />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Di~~~ii~~~':' . . . . . . . . . . . . . . . . . . . . . , . . . . . , . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . , . . . . . . . . . . . . , . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . , . . . . . . , . , . . . . , 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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />