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s�s-7ao-oozo Gifiy ot �epnyrnins r�rnu� HNN���a����� � <br /> . . Building Department <br /> Date Receivecl -^ 2� Phone Contact for Permitting <br /> 8/,� 7�� �S3/f� <br /> �^� �D����j� f . Owner Phone Number <br /> Owner's Name /- <br /> Owner's Address 39�� �����'T `a"� Owner Phone Num�er <br /> Owner Phone Nurriber <br /> Fee 5imple Titleholder Name . <br /> Fee Simple Titleholder Address !� . <br /> JOB ADDRESS �3YSy� � r' �� /� _ LOT t� <br /> �(` �l.0 O�J � PARCEL ID# °�' �- °2 "� _�— D �� �/� � OV7v <br /> SUBDIVISION • (013TAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED NEW CONSTR e ADD/ALT [� SIGN � MOVE Q DEMOLISH <br /> � INSTALL REPAIR <br /> PROPOSED USE 0 SFR �� • COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK 0 FRAME �. 0 STEEL 0 OTHER <br /> , � . <br /> DESCRIPTION OF WORK ' �^" � f ��� � �� . <br /> BUILDING SIZE �T� X�y�� SQ FOOTAGE ��G HEIGHT <br /> •� BUILDING $� 9� �� ' VALUATIaN OF TOTAL GONSTRUCTION <br /> I\A ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> ��� �ASC� �ERMIT �EF�vI�� <br /> 0 PLUMBING � (813) 788-531 <br /> F,4X 1-�6-8247�� - <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION . <br /> ��� � � Z� V l <br /> � GAS � ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES QNO .� <br /> BUILDER �_ �'��� .� �ll��� ��� � � �) COMPANY �1 J � �'�^ ` �' � <br /> SIGNATURE "��'"' b` REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address �/S TO' r �-1� . License # <br /> ELECTRICIAN � ,���/ ' .� � a �•�I b COMPANY /nDrs� � '�-'�� <br /> SIGNATURE ���/ ` ` REGISTERED Y/ N FEE CURRENT Y/ N <br /> Addres� /� ' d � � /� License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # I <br /> MECHANICAL � ���/�� • ', /� Q� COMPANY �(/�-+�' V /�O e �f�,�e <br /> SIGNATURE /���C�L�'rl/� v REGISTERED Y/ N �FEE CURRENT Y/ N <br /> Address �y�� .^�-1�41` License# <br /> OTHER � COMPANY ' <br /> SIGNATURE RGGISTERED 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) worl<ing days after submittal date. Required on$ite, Construction Plans, Stormwater Plans w/ Silt Fence fnstalied, <br /> Sanitary Facilities & 1 dumps#er; Site Worlc Permit for subdivisions/large projecfs <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-Q-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 uVori< Perm(t for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (�) sets of Engineered Plans. <br /> **"*PROPERTY SURVEY required for all NEW construcEion. ' <br /> � � ; I ' : �-i-�;-Fi-;-i°f°� '�; ; ; <br /> - � , � <br /> Directions: <br /> Fill out appllcation completely. <br /> Owner & Contractor sign back of application, notarized ' <br /> If over $2500, a Notice of Commencement is required. (AIC 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 PERMITf'ING (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 />