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813 Gity ot Lepnyrnins re�, � u� r+NN���a���� � <br /> , Building DepartmenE <br /> Date Received �� ,'' phone Contact for Permitting ��� � "��/ <br /> Owner's Name <br /> ����.,� � �'f Owner Phone Number �/`� � 7 � � � <br /> Owner's Address `�3�d � ��' �• r Owner Phone Number <br /> Fee Simple Titleholder Name • Qwner Phone Nutriber <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS J 3�v I�� � � LOT # � a' <br /> SUBDIVISION <br /> O'F /�/�[,1�1 PARCEL ID# lI �'d1-� �OID /���d "� O oL�- <br /> (OBTAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN [� MOVE Q DEMOLISH <br /> � INSTALL e REPAIR <br /> PROPOSED USE 0 <br /> SFR �• COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK 0 FRAME 0 STEEL [� OTHER �— <br /> DESCRIPTION OF WORK ' re �� � a x ` �� r <br /> BUILDING SIZE � X� 7 SQ FOOTAGE ��O` HEIGHT <br /> � BUILDING $/ S 0� VALUATION OF TOTAL GONSTRUCTION <br /> , <br /> C] ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY [� W.R.E.C. <br /> . PASCO PERMIT 3ERVIC� <br /> � PLUMBING $ �$�3� �14 <br /> FAX 1-896-824-7894 <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> . . �I�B <br /> � GAS 0 ROOFING � SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [�YES QNO <br /> BUILDER COMPANY Ou//�- r <br /> SIGNATURE REGISTERED Y I N FEE CURRENT Y/ N <br /> Address s3/d �7''� J r `� F' �icense # � <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 # I <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) worl<ing days after submittal date. Required onsite, Construction Plans Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsfiarge projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plUS a Life Safety Page; (1) set of Energy Forms. R-O-W Permft for new construction. <br /> Minirnum ten (10) worlcing 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 projecEs. All commercial requirements must meet compliance <br /> SIGN PERMIT AtEach (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 $5000) <br /> *` Agent (for the contractor) or Power of ,4ttorney (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 (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways.:needs ROW <br />