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813-78D-0020 Gity or �epnyrnnis re� �►u� ��N���a���� � <br /> Building Department <br /> � � � �/� 7� -- s�3/ y <br /> Date Received Phone Contact for Permitting <br /> - - F c �ls�C �c.� �6 ra...i,rx�r�d �'/ 3 Sy/- �,S'S�7 <br /> 12 Owner Phone Number <br /> Owner's Name � /_ <br /> � � P3 y�t C�CIf�° cT Owner Phone Number <br /> awner's Address <br /> Owner Phone Nurriber <br /> Fee Simple Titlehoider Name <br /> Fee Simple Titleholder Address �� <br /> �/ L..�.�. At�K J� � � � LOT # � <br /> JOB ADDRESS � � 7 G <br /> �Yf ' • �sf�GC.. �Q1e`l PARCEL ID# o�r — e� II��� ��dv! �dl U <br /> SUBDIVISION (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR e ADD/ALT 0 SIGN [� MOVE [� DEMOLISH <br /> � INSTALL REPAIR <br /> PROPOSED USE 0 <br /> SFR �- COMM 0 OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK � FRAME 0 STEEL. 0 OTHER <br /> DESCRIPTION OF WORK <br /> ro0�n �n� � �n �- � d/�- � � <br /> BUILDING SIZE � d-- X yS SQ FOOTAGE S�O HEIGHT <br /> � BUILDING ��, 7 � 3 . S'/ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ ' AMP SERVICE [� PROGRESS ENERGY [� W.R.E.C. <br /> � <br /> 0 PLUMBING � P��ftA PERMITBERVICE <br /> (813) 788-6314� <br /> � MECHANICAL $ � VALUATION OF MECHANICAL INSTALLATION ��( 1.�.�,��� <br /> � GAS 0 ROOFING � SPECIALTY 0 OTHER ��I W'T <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES QNO <br /> BUILDER p COMPANY ��^ `� '��� � � <br /> SIGNATURE "�"" `����" —""� REGISTERED Y/ N FEE CURRENT <br /> Address � Yyo �� Z � License # <br /> ELECTRICIAN � �! COMPANY ��'� �'�"'C�`'�' +ti ' <br /> SIGNATURE C` / �� L ' —�`�' REGISTERED Y/ N FEE CURRENT / N <br /> Address � y � Q'7 �� � • , � ' License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> � COMPANY V�� f ��O � <br /> MECHANICAL �����y , � <br /> SIGNATURE /�dL���/"r"'"'J REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address /l. /� � License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � <br /> RE5ID�NTIAL 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 submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence (nstalled, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach {3) complete sets of Building Plans plus a Life Safery Page; (1} set of Energy Forms. R-O-W Perm(t 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 Worl< 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. (AlC 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 A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />