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• 813-780 -0020 C of Z P A Fax- 813-780 -0021 Building Department / l 6 2 Date Recelv 4 iA p [ Phone Contact for Permittin • i /3 - 1 zial o ier's Name • 2:'G" t°`'I ( V el- G > t ' 1`' Owner Phone Number • Owner's Address I X9,/a - 347 6 - 37:t I der Phone Number I I5 943 317 Fee Simple Titleholder Name) Owner Phone Number I I • • Fee Simple Titleholder Address I -'� I • JOB ADDRESS 1 6, V r • 0'd a 10'• i 146 I LOT # I PARCEL I' ,.'� ,& 00 (0 0 • o SUBDIVISION. (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR I I ADD /ALT n SIGN n MOVE n DEMOLISH • INSTALL REPAIR PROPOSED USE . n SFR r COMM n OTHER TYPE OF CONSTRUCTION n BLOCK n FRAME in STEEL n OTHER I i DESCRIPTION OF WORK 1.1 6j3 U ''J t}`. C1 "5 E 5 C fi L `' BUILDING SIZE 1 SQ FOOTAGE I HEIGHT 1 • n BUILDING $ • VALUATION OF TOTAL CONSTRUCTION 1 pL ELECTRICAL $ 4yR 4.1`' AMP SERVICE n PROGRESS ENERGY • El W.R.E.C, PLUMBING I$ • n MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION • • n GAS n ROOFING r- SPECIALTY n OTHER • FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA r IYES [ NO • BUILDER COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I Address ( . License # I . ELECTRICIAN 4,21-.Kt c v COMPANY SIGNATURE / REGISTERED ' I Y / N I FEE CURRENT ( Y / N i Address ( 1 1 ... )/ 1, 1/ , ' w/ f : t 1 c License # 1 re..`� (4- I PLUMBER • . COMPANY 1 SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I . Address I 1 License # 5 • MECHANICAL COMPANY • SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address 5 • • I License # • I OTHER COMPANY 5 SIGNATURE REGISTERED i Y/ N I FEE CURRENT I Y/ N Address ( ( License # 5 • RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum. ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence Installed, Sanitary Fadiities & 1 dumpster, Site Work Permit for subdivisions/large projects 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. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance • SIGN PERMIT Attach (2) sets of Engineered Plans. 'PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. • Owner & Contractor sign back of application, notarized • If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) •' Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service. Upgrades A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways.:needs ROW •