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813-780-002D Gity ot Gepnyrniiis renn�� ��N���a����� � <br /> Building Department <br /> Date Received C�hone Contact for Permifting ��` �� "" S � / <br /> Owner's Name <br /> T Fr� Z • Owner Phone Number <br /> Owner's Address 3�9537 �-�'l d Owner Phone Numher <br /> Fee 5imple Titleholder Name pwner Phone Nurriber � <br /> Fee Simple Titleholder Address <br /> �-� � � Q� • LOT # oZ� <br /> JOB ADDRESS � • <br /> /YI �� SL(.C. OW�-�3 PARCEL ID# e�-y— e2�, `D�,I— v� ' dO�OO= DO�D <br /> SUBDIVISION �_ (013TAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSEb ' NEW CONSTR e ADD/ALT � SIGN [� MeVE Q DEMOLISH <br /> � INSTALL REPAIR <br /> PROPOSED USE 0 SFR ' [� • COMM � OTHER <br /> TYPE OF CDNSTRUCTION Q BLOCK � FRAME � STEEL 0 OTHER � <br /> DCSCRIPTION OF WORK � I x � 3 �"�� <br /> BUILDING SIZE �a' X�� SQ fOOTAGE �S(0 HEIGHT <br /> � BUILDING $��O D�' VALUATION OF TOTAL GONSTRUCTION <br /> � PROGRESS ENERGY 0 W.R.E.C. <br /> � ELECTRICAL I$ -- AMP SERVICE 0 � <br /> � ],� l Z �A� F�EAMIT s�4�e/4�� <br /> � PLUMBING $ Y� (813) 7�8-53'9� <br /> �i4)(1-866-8247�9� <br /> 0 MECHANICAL $ VqLUATION OF MECHANICAL INS7ALLATION � �� <br /> . � <br /> GAS ROOFING � SPECIALTY � OTHER `�i� <br /> � � � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES QN 1 <br /> BUILDER " /��� . �� ` COMPANY "� � J ` • ZnC • <br /> SIGNATURE /` v^" �l REGISTERED Y/ N FEE CURRENT Y! N <br /> Address �D /S y /� � �C 2 � � License # <br /> ELECTRICIAN • COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> • License # <br /> Addres� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Add�ess License # � <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 Buifding Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br /> Minimum ten (10) worl<ing days after submittal date. Required onsife, Construction Pians, Stormwater Plans w/ Silt Fence fnstalled, <br /> San(tary Facilities & 1 dumpster; Site Worlc Permit for subdivisionsllarge projects <br /> COMMERCIAL Attacli (3) complete sets of Building Plans plUS a Life Safety I'age; (1) set of Energy Forms. R-O-W Permit for new construction. <br /> Minimum ten (10) worlcing days after submittal date. Required onsiEe, Consfruct(on Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster. Site Woric Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> � � _,_�_, . � � <br /> Directibns: . . <br /> Fill out appiicatfon 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 notariied letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) ' <br /> Reroofs Sewers Service.Upgrades AIC Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />