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813- 78U-UULU t/Ily 01 LCp11y1I IItI rol I Iun npNnvau J'' • Building Department • Date Received / - 2 -io Phone Contact for Permitting 8 / ___ __ / 1 " 03 6:3 Owner's Name Ae -NA/AQ I/ OA1415. • Owner Phone Numbe ( e/ 3� 7( 9 �- . 5 2 77 • • Owner's Address ((v 00 N lJfSrJ/FOR.E. &fro 1 44 FILJ3(,4I Owner Phone Number I Fee Simple Titleholder Name) - I Owner Phone Number Fee Simple Titleholder Address I JOB ADDRESS & 320 - /./ ii L.. y I- - A v / 7EP�yie///tiJ,f--L '3350 I LOT # /o/ / SUBDIVISION ,� 1 6 . /°94J. .1 PARCEL ID #I 0 3— 4- 21 ` 0230,-.00000—Y0 /0 I (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED • p•-■ DEMOLISH NEW CONSTR I I ADD /ALT n SIGN n MOVE e INSTALL REPAIR PROPOSED USE' . n SFR ' 1 $ - COMM I I OTHER 1 1 TYPE OF CONSTRUCTION BLOCK I . I FRAME n STEEL n OTHER DESCRIPTION OF WORK • I IVEN CO/VST2U:•r 0/U -7-04vN, O/✓J0s I • BUILDING SIZE I 1 SO FOOTAGE I / 3 7 / I HEIGHT 1 a `" oed I , BUILDING $ ./ ' 6 5 7 VALUATION OF TOTAL CONSTRUCTION , I 1 ELECTRICAL $ AMP SERVICE PROGRESS ENERGY n s yo W.R.E.C. 1 1 PLUMBING $ Y325 n MECHANICAL $ 41 vs VALUATION OF MECHANICAL INSTALLATION 1 I GAS 11 ROOFING 1 1 SPECIALTY 1 I OTHER • FINISHED FLOOR ELEVATIONS 9 / • I FLOOD ZONE AREA 1 IYES FIND BUILDER COMPANY LSiv/l'- I/ 0A14": . REGISTERED Y/ N SIGNATURE / REG � I FEE CURRENT ' I Y/ N 1 • Address - P 0 /V • k/ . " cy er BLVD �rr T � 3360 9 License # C 13G/ S 51.5I ELECTRICIAN �.-�_�. C OM PAN Y fD/ �°, SJ e CCe =CTS /G � N C C . ..., SIGNATURE � � REGISTERED • I Y / N I "'FEE CURRENT I Y / N Address I , / 01/ - ',p / -24M �L 336/ • License # EC 00 (7-2.5 79 PLUMBER 7 COMPANY S /-UM6 /N& SIGNATURE — REGISTERED i Y/ N 1 FEE CURRENT I¥/ N I Address ( 6317 /-i " o /S ,. /2l 1.64.1//4-0/4_ 35$V8 u 5 cense #• `' CPC e9,2/.5 7/ 0 _ . eQ y O /1/!�-/fGA±7d UR &' ,4 77 Of /7 MECHANICAL / COMPANY SIGNATURE // REGISTERED Y/ N 1 ENT I Y/ N Address A O *• Bo S o8 . 43Ryover/O N r, FL- 3y4 ?V1 License # c2 9 ii: 5 S © 6 2 OTHER . / COMPANY C! �'rEez,/ tik;, ljJ 9[i ry leopFi�f/G sZvc. SIGNATURE • REGISTERED 1 Y/ N I FEE CURRENT I• Y/ N l• • Address '/2 . .5#OIQ L /uF StVo 4P241/ G //a z, L63slo? ucense # I "C Co z 99 ./ RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; ii-O -W Permit for new construction;: Minimum. ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Slit Fence Installed, Sanitary Facilities & 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,Permlt 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 Attorney (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 . -