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813 - 780 -0020 City oT Lepnyrnnls ret llul / NNpiluQLikil . 'l , <br /> Building Department . / 0� <br /> Date Received e -- - 0 Phone Contact for Permitting -- <br /> Owner's Name Re.-i e.t.a..' <br /> .0 . 9 / 99f Owner Phone Number <br /> Ili �l -r/�0/n l <br /> Owner's Address I � � Owner Phone Number <br /> Fee Simple Titleholder Name' <br /> Owner Phone Number I <br /> Fee Simple Titleholder Address I <br /> JOB ADDRESS 1 <br /> 311 2 lC LLI 7/-aH/7 I LOT # 10 7 <br /> SUBDIVISION 4 1nhvenle c DGa f I PARCEL ID#1 e2 V -04 -pl./- W ooioo- oayO <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR I ADD /ALT I I SIGN I I MOVE I 1 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 1 I SFR I COMM I I OTHER I <br /> TYPE OF CONSTRUCTION I I BLOCK I I FRAME I I STEEL I I OTHER I <br /> DESCRIPTION OF WORK I' Go, a_0/ = -�� pa� <br /> BUILDING SIZE /3 SQ FOOTAGE , j I I HEIGHT I I <br /> 10 BUILDING $ e201 • t� VALUATION OF TOTAL CONSTRUCTION <br /> EV ELECTRICAL $ AMP SERVICE xi PROGRESS ENERGY 1 1 W.R.E.C. <br /> Ev PLUMBING $ PASCO PERMIT :.1 - r <br /> EP ( 81 3) 788-5314 78 <br /> MECHANICAL $ VALUATION OF MECHANICAL INST• LATION 1- �96.624Z4 -7894 <br /> I I GAS I I ROOFING I I SPECIALTY 1 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 'YES I I NO <br /> �J <br /> BUILDER �p,���� <br /> J <br /> PI <br /> ` *\') - CMPANY 1%504. . Cr LAC • • • <br /> SIGNATURE 1 REGISTERED I Y / N I FE C RRENT I Y / N I <br /> Address (0 / F-0/`, t_Elts Ad 3 . ih2 p/. _/ License # <br /> • <br /> ELECTRICIAN • ' /.J " t " COMPANY Cf , � I Ggi 1�CGthGC <br /> SIGNATURE ter' - REGISTERED L Y/ N 1 FEE CURRENT I Y/ N I <br /> Address 4,933- ( r -- 4 /`A-- Ail Ze /t " " Alo License # • 1 <br /> PLUMBER COMPANY D(U -- /ze �� J <br /> SIGNATUREC� ���� REGISTERED I Y/ N I FEE CURRENT Y/ N I <br /> Address �„ License # r <br /> MECHANICAL COMPANY ' <br /> `,_,y -, �/����� , c v V�IJ`f ��C <br /> SIGNATURE 'fe �� /�� ` �-f4w \ REGISTERED I Y / N FEE CURRENT I Y / N I <br /> Address License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED L Y/ N 1 FEE CURRENT 1 Y/ N I <br /> Address License # F <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-0-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-0-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 /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) <br /> ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades NC Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />