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813-780-D02D City ot G�pnyrnins rc:�nu�HNN���a����� � <br /> . Building Department <br /> Date Received �—" 7i f�hone Contact for Permitting �/� ?dQ • -- 5��7' <br /> -H1-I'i . <br /> Owner's Name �/ � T E- e � Owner Phone Number <br /> Owner's Address 3�s y� ���Q� �� Owner Phone Number <br /> Fee 5imple Titleholder Name Owner Phone Nurriber[ <br /> Fee Simple Titleholder Address <br /> �,,�y�- � ' LOT# �� <br /> JOB ADDRESS � `�y ' �n-�"""� • <br /> �t� WG da�tl' PAI�CEL ID# �02-� 'a��OO���I�^w�v <br /> SUBDIVISION • (OI3TAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED ' NEW CONSTR e ADD/ALT 0 SIGN 0 MOVE �] DEMOLISH <br /> � INSTALL REPAIR <br /> PROPOSED USE' 0 <br /> SFR ' 0 • COMM � OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK � FRAME ' .0 STEEL 0 dTHER <br /> D[SCRIPTIONOFWORK CQil.. IT CI��� � COAGLQ.-J�- • <br /> BUILDING SIZE �s � x /�(� SG!fOOTAG[ �cl�� HEIGI-IT <br /> � � BUILDING $ �� Q�I� � VALUATION OF TOTAL CONSTRUCTION <br /> � ELECTRICAL $ , <br /> AMP S�RVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> • 2�7( ' ��P���IBT s��w���� <br /> � PLUMBING $ � � t813,788-53�� <br /> E/�C 1�-i22}-7��� <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION / `� <br /> • '�.���°�-� <br /> � <br /> GAS � R O O F I N G � S P E C I A L T Y 0 O T h I G R . � <br /> FINISHED F L O O R C L E V A T I O N S 1=LOOD ZONE AREA [�YES ONO <br /> BUILDER ///�� ����� COMPANY <br /> �&n cl > �� . <br /> � � FEE CURRENT Y!N <br /> SIGNATURE ` /1��-a�i-tKl/,(� . � REGISTERE� Y/ N <br /> Address ��� �� � . License# <br /> ELECTRICIAN • COMPANY <br /> SIGNATURE REGISTERE� Y/ N FEE CURRENT Y 1 N <br /> . License# � <br /> Addres� <br /> PLUMBER COM1'ANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> License# <br /> Adclress <br /> MECHANICAL COMPANY . <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> License# � <br /> Address ' <br /> OTHER � COMPANY ' <br /> SIGNATURE REGISTERED Y/ N PEE CURRENT Y/N <br /> License# I <br /> Address <br /> RESID�NTIAL Attach(2)Plof Plans;(2)sets of Building Plans;(1)set of Cnergy Forms;R-O-W Permft for new construction, <br /> Minimum ten(10)worl<ing days after submitta!data. Required onsite,Construc�ion Plans,Stormwater Plans w/Silt Fence fnstalled, <br /> Sanitary Facil(ties&1 dumps�er;Sife Worlc Permit for subdivisionsllarge projects <br /> COMMERCIAL• Attacli{3)complete sets of Building Plans pius a Life Safety f'age;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)worlcing days after submittal date. Required onsite,Construcfion Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary�acilities&1 dumpster.Site Wori<Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach.(2)sets of Engineered Plans. <br /> ****PROPERTY SURVEY roquired for ail NEW construction. ' <br /> ,,�--'-'-'-I-1-I-t-I-rn-mri-rrri-ri-ri-ri-rP`�'�� <br /> -i-Fhl+��-F;-ri-i-�-f-f-t-f-H-I-1-H-1-H-1-1-1+1-1-l-1-I-1-1-1-1-f-1-I-I-I-f-I-I-I-1-f-1-I-I-I-1-}-H-H-H-1-1-I-I-H-{-1-1-I-1-(-f-1-i-H+1-I-f-H-I-1-i-1-M-Fi°i-i-n-ri-��� <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. (AIC upgrades over$5000) <br /> ** Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same - <br /> OVER THE COUNTER PERMITTING (Front of Applicafion Only) � <br /> Reroofs Sewers Service.Upgrades A/C 1=ences(PlotlSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways.:needs ROW <br />