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a�s-7ao-oo20 , . Lity ot Gepnyrrniis rer►�n� HNN���a����� <br /> Building Department <br /> Date Received Phone Contact for Permitting ��` �� " `�`�`� <br /> Owner's Name �G-CK L'�U��h Owner Phone Number <br /> Owner's Address 3 � ya �"�-' "� Owner Phone Number <br /> Fee Simple Titlehoider Name Owner Phone Nurriber <br /> Fee Simple Titieholder Address �� <br /> � G�.� � �j LOT # � <br /> JOB ADDRESS c3 y <br /> SUBDIVISION <br /> I�'IQ e�1W�- �!u`� PARCEL ID# °ZT_oZG —o2/—G�I�•— �OI(�() — D� <br /> (OBTAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR e ADD/ALT [] SIGN � MOVE �] DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 0 <br /> SFR 0 COMM 0 OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK � FRAME � STEEL Q OTHER <br /> DESCRIPTION OF WORK S� � f�n r� � �� <br /> BUILDING SIZE � x37 SQ FOOTAGE ��/ HEIGHT <br /> � BUILDING $ ���, � VALUATION OF TOTAL CONSTRUCTION <br /> ' PROGRESS ENERGY Q W.R.E.C. <br /> 0 ELECTRICAL $ AMP SERVICE [� <br /> [� PLUMBING � .� �(1 �i� pA.SCO PERMIT SERVICE <br /> (813) 7�-� <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION FAX 1'�"�' <br /> � GAS Q ROOFING � SPECIALTY � OTHER ��I�l , <br /> l� <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA DYES ONO <br /> BUILDER �j e / ` 4 COMPANY �Cl,/1 V �G�^ �� C ' <br /> SIGNATURE �`�"c�7 +"w-�� �'1d/� F2EGISTERED Y/ N FEE CURRENT Y/ N <br /> Address �e. l� 0� /� C /�' /N � License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRENT Y/ N <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � � <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 submittai date. Required onsite, Construction Plans Storrnwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsAarge projecEs <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 construct(on. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilides & 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 constructfon. <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 PERMI7TING (Front of Application Only) <br /> Reroofs Sewers Service.Upgrades A/C Fences (Plot/Survey/Footage) <br /> ❑riveways-Not over Counter if on public roadways..needs ROW <br />