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s�saso-oozo City ot �epnyrnius rer�,n� HNN���a����� <br /> . Building Department <br /> Date Received - —�( Phone Contact for Permitting ��J 7 � ��' � <br /> Owner's Name <br /> � ,f- /�./Y �j V7 f' Owner Phone Number 7�� " 3 �� <br /> Owner's Address 7�33 ��a� �� � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Nurriber <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � a-�- � �Q� LOT # � �� <br /> /I�I�L 4 P�f� �Q-� PARCEL ID# °�"7 - 'a-�! -°I'� OQlIO '" Od �O�'' �9v <br /> SUBDIVISION (pBTAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT [� SIGN CJ MOVE �] DEMOLISH <br /> � INSTALL e REPAIR <br /> PROPOSED USE 0 <br /> SFR 0• COMM � OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME � STEEL OTHER <br /> DESCRIPTION OF WORK ��`'w C d�T D�r 'C�� • � <br /> BUILDING SIZE �` �� 7 � S4 FOOTAGE 7�l HEIGHT <br /> �] BUILDING $ � � VALUATION OF TOTAL GONSTRUCTION <br /> 0 ELECTRICAL $ AMP SERVICE [� PROGRESS ENERGY �] W.R.E.C. <br /> , F�A3C.'C) PERMIT SERVICE <br /> 0 PLUMBING � (813) 788-5314 <br /> FAX 1$66-824-7894 <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> . ��� <br /> Q GAS � ROOFING � SPECIALTY � OTHER �y'�( � <br /> FINISHED FLOOR ELEVATIONS <br /> FLOOD ZONE AREA DYES �NO ��� <br /> BUILDER � � �5�, J COMPANY � � ' � ' <br /> SIGNATURE l REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address �� �� 7 Z" r'" License # <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 # C <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 /> RESID�NTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) sef of Energy Forms; R-O-W Permit for new construction, <br /> Minimum ten (10) wori<ing days after submittal date. Required onsite, ConstrucEion Plans Stormwater Plans w/ Silt Fence fnstalled, <br /> Sanitary Facilities & 1 dumpster, Site Work Permit for subdivisionsllarge 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 /> 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 Worl< Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> "'`**PROPERI'Y 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 P;ttorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI'fTING (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 />