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813-780-UUZU c;ity ot �epnyrnuis rermit Hppncauon ��'�a;c-o�.a-rov-uvc� <br /> Building Department � �� <br /> Date Received �,,, �. � Phona Contact for Permittin � <br /> i �p <br /> Owner's Name � Owner one Number � -� 0 <br /> Owners Address � ���� Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS I d � l I� 5 � L�-�C'�'� � 1 1J LOT # � <br /> SUBDIVISION ` v 5 , PARCEL ID# � - `" � � G ` � �YJ � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR 8 ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK � �L%' ,J � �- Q � 2� / � ,U? <br /> BUILDING SIZE SQ FOOTAGE � HEIGHT <br /> UILDING $ D VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL �— AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING � / � 1 � Z � ✓, <br /> v� j � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION� !,) C/� CiCL� <br /> (�� l � <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER �"S <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES � �� <br /> 0 5 % �r' IG� <br /> BUILD 1� � COMPANY � � M�- � L4� <br /> SIGNA ���-- REGISTERED Y/ N FEE CURRE� Y J N <br /> Address yc� � � License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # —� <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # —� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address Ucense # <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) working days after submittal date. Required onsite, Constructlon Pians, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivtsions/large projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Ufe Safety Page; (1) set of Energy Forms. R-O-W Permit for new constructlon. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> "`*PROPERTY SURVEY requlred for all NEW constructlon. <br /> , <br /> ll�firlTfI111T11111'11111�1 R I <br /> � ���+++� �+++ �+a.LLI 61J� 1� I i�1i1L1 1 1 W 111 1 JJi I <br /> Dlrectfons. <br /> Fill out application completely. <br /> Owner & Contractor sign back of appUcatlon, notarized <br /> If over s2500, a Notice of Commencement is required. (AJC upgrades over iT500) � <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 PERMITfING (Pront of AppUcation Only) <br /> Reroofs if shingles Sewers Service Upgrades AfC Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on publlc roadways..needs ROW <br />