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813-780-0020 City ot [ephymius Nermit �►ppucation ra�-o�o-iov-wc� <br /> Building Department <br /> > `� <br /> Date Recefved one Contact for Permittin — <br /> Owner's Name Owner Phone Number <br /> Owne�'s Address �'� � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT # � <br /> SUBDIVISION , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE � SQ FOOTA HEIGHT <br /> QBUILDING �� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> t � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I� v <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER ' COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address cense # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ <br /> Address J <br /> 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 /> M(nimum ten (10) working days after submUtal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Stlt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Work Permit for subdivisfonsllarge projects <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 construction. <br /> Mi�imum te� (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster. Site Work Permit for all new projects. All commerciai requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> '"'*PROPERTY SURVEY requlred for all NEVy construcUon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner 8� Confractor sign back of application, nota�ized ' <br /> If over 52500, a Notice of Commencement is required. (AIC upgrades over s7500) <br /> '" Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (PIot/Survey/Footage) <br /> Driveways-Not over Counter if on publlc roadways..needs ROW <br />