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s�saao-oo2o Cifiy ot �epnyrnnis rerr�u� h��,���a����� , <br /> • Building Departmenf <br /> Date Received O� Z �� Phone Contact for Permitting �lJ /oo •- ��l T <br /> Owner's Name � (�-Jl /" • Owner Phone Number <br /> Owner's Address 3-.�� , /'e�//�-�� •�� Own�r Phone IJumber <br /> Fee Simple Titleholder Name Qwner Phone Nurriber <br /> Fee Simple Titleholder Address � <br /> JOB ADDRESS 37S � �U /�-F/I�l �� � LOT �k �� <br /> SUBDIVISION . �'/� ��/�� �-/ PARCEL ID# �7 - °�" ��"' �y�"'�� � Oc3I � <br /> (OBTAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED ' NEW CONSTR ADD/ALT 0 SIGN 0 MOVE [� DEMOLISH <br /> � INSTALL e REPAIR <br /> PROPOSED USE � SFR ' �• COMM � OTHER <br /> TYPE OF CONSTRUCTION BLOCK � FRAME �. � STEEL 0 OTHER <br /> DESCRIPTION OF WORK � �DU� � • �h �� �� ��� . <br /> BUILDING SIZE /e2- %(o Y 6 X� SQ FOOTAGE / D HEIGHT �_ <br /> � BUILDING $���, pF' VALUATION OF TOTAL CONSTRUCTION <br /> [�] ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY [� W.R.E.C. <br /> � PLUMBING � � ��� �ERMBT SEF��/��E <br /> (813} 788-53�� <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� 1-�-�247� <br /> � ���(� � <br /> � GAS 0 ROOFING � SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA DYES ONO <br /> BUILDER � ' � COMPANY � r �`� ' � � <br /> 51GNATURE � REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address �-Y�� �� � �� � ' License # <br /> ELECTRICIAN , ' / e 1 COMPANY /,(�- • �L�GCr <br /> SIGNATURE ��� ��L� �' REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address � � �� ' '� � • License # <br /> PLUMBER COM1'ANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � <br /> MECHANICAL � � COMPANY ��f �rD �� � � <br /> SIGNATURE •�� �' REGISTERED Y/ N FEE CURRENT Y/ N . <br /> Address yy�� 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 Buifding Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br /> Mlnimum ten (10) worl<ing days affer submittal date. Required onsite, Construcfion Plans Stormwater Plans w/ Silt Fence fnstalled, <br /> Sanitary Facilities & 1 dumpster, Site Wori< Permit for subdivisions/large p�rojects <br /> COMMERCIAL Attacli (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new constructlon. <br /> Minimum ten (10) wori<ing days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpsfer. Site Worl< Permit for all new projects. All commerciaf requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> '**"Pf20PERTY SURVEY required for all NEW construction. <br /> -- .�. - '���� <br /> Directions: <br /> Fill out application completely. • <br /> Owner & Contractor sign back of application, notarized � <br /> If over $2500, a No.tice of Commencement is required. (A!C upc�rades over $500D) <br /> '`* Agent (for the contractor) or Power of ,Atfomey (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 /> �riveways-Not over Counter if on public roadways.:needs ROW <br />