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813-780-0020 t;ity ot �epnyrnins rermit Hppiication rax-oio-�ou-uvc.i <br /> Buildfng Department <br /> /l�Or✓ � c fj <br /> Date Received ` '� �� — l phone Contact for Permittin �� :� �_ <br /> Owner's Name Z• � 1 I �� � Owner Phone Number ��' S`� '� S�o� <br /> Owner's Address ���� G� /� /4 I` i� (�2,. Owner Phone Number � �� <br /> Fee Simple Titleholder Name Owner Phone Number �— � <br /> Fee Simple Tftleholder Address <br /> JOB ADDRESS r O � P�� ��''� �C.'��h �i'�I ! I�S C L 33.sy 2. LOT # � b <br /> SUBDIVISION �'���1y/!�j �(�S � fZ/, �(•1'tS PARCEL ID# �." Z-�' 2l `C� O 3C� -��O Z,OO � fJ ! G` Q <br /> {OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR [� ADD/ALT � SIGN �] MOVE � DEMOLISH <br /> INSTALL �' REPAIR <br /> PRpPOSED USE � SFR � COMM 0 OTHER <br /> TYPE OF CONSTRUCTION BLOCK � FRAME Q STEEL Q OTHER <br /> DESCRIPTION OF WORK lA C.�_ �� �,U�`� � ,� N r�S S� �?{ l //LG� , L-f . 3 <br /> F� r�37z, r <br /> BUILDING SIZE " 3Q FOOTAGE HEIGHT <br /> Q BUILDING $ �.. � �/ VALUATION OF TOTAL CONSTRUCTION <br /> !CJ <br /> 0 ELECTRICA� $ AMP SERVICE , 0 PROGRESS ENERGY Q W.R.E.0 <br /> 0 PLUMBING $ � ��� � <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> 0 GAS � ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA OYES QNO <br /> '� -269- S ON�cA <br /> � �-�. `��� � � e. ev rZ� <br /> BUILDER � _��� � `^-[� ' COMPANY � �I , <br /> SIGNATURE ' ' REGISTERED N FEE CURRENT Y/ N <br /> Add�ess � 1 (� ��� ��, � � � Ucense# ` C��voT� � <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 • � � <br /> License # <br /> OTHER COMPANY <br /> SIGNATIJRE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address Llcense # —� <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br /> Miiimum ten (10) working days after submittal date. Requfred onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> San(tary Facfl(tles 8 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new constructio; �. <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 commerclal 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 applicatlon completely <br /> Owner & Contractor sign back of appiicatlon, notarized <br /> If over;2500, a Notice of Commencement Is required. (A/C upgrades over a500U) <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 Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />