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813-780-0020 c;ity ot Cepnyrni�is Nermit Rpp�ication raX-�,,�-�u�-uu�, � I <br /> Building Department � <br /> . � �� <br /> Date ReCelved 3•- �� Pho�e Contact for Permittin � OI) � -- ���V <br /> Owner's Narne �) w1 tt l� d�fs , ner Phone Number .- f <br /> �_.-_.�_�_..�.__- " <br /> Owner's Address � l 1��R, T' �j' L,L.� e i(Z . Owner Phone Number <br /> Fee Simpie Titleholder Name �-"� � Owner Phone Number <br /> Fee Simple TitlehoJder Etddress <br /> JOB ADDRESS C� S� iry1 � (t��({�,�j� — � i �,� L; C�� LOT # �� <br /> SUBDIVISION �R-b�'sl U ( ��t1 c�G� PARCEL ID# S '25 � •—'Q� �O -- a0pbp '�' L�� �O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR � ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR [� COMM � OTHER On <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK N EW PO(�(.. � S�/� �' ��C,�j — F� � JC �Q ((�7 L.V / <br /> BUILDING SIZE � SQ FOOTAGEC� HEIGHT �— <br /> ILDING $� �,,,�r� VALUATION OF TOTAL CONSTRUCTION <br /> 37VV <br /> �ELECTRICAL �� AMP SERVI E A * PROGRESS ENERGY Q W.R.E.C. <br /> �� ��,� j <br /> OPLUMBING $ �� ,� l I • )/, � J ' <br /> �� � � W v L� <br /> � � �� � <br /> OMECHANICAL $ VALUA� F MECHANICAL INSTALLATION �'�� <br /> � <br /> �GAS � ROOFING Q SPECIALTY � OTHER r ttG � <br /> �, �� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES �._� <br /> C] ( ,� y � , � � �'��� <br /> � <br /> BUILDER r \ �' � COMPANY w RY� � c�,� (,`�,,� .0 � �� � �' � <br /> SIGNATURE W �� � REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address �� 3 I� l� t 9 p N• �I � � License # CPC �N S�l bb <br /> � .. <br /> ECTRICIAN �/�� COMPANY �I.=TZ �Z�C�cc - i�.3C� <br /> IGNATURE �� -, REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address /l�3 /i.+��e �ec� U�, /,Rlt�lk«,d� � '�, 3Bus License # �_ � <br /> �-� � 300,� i '� � <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 �— � License # � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address � License # � <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Pians; (1} set of Energy Forms; R-O-W Permit for new construction, <br /> iviinimum ten ��0) working aays after submittat aate. kequired onsite, CcnsUUCUon Plans, 5tormwater Pians w/ �ilt �-ence ins[allea, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach (31 complete sets ot Suilding Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-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 $7500) <br /> "' Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authoriiing same <br /> OVER THE COUNTER PERMI771NG (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />