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813-780-UOZU Vity or�epnyrnius rerrni�r1NNn�auv�� � �^��� ��� ���� <br /> Build(ng Department <br /> �nv�v�C.:� <br /> Date Received Phone Contact for Permittin 0�3 Zfo`�1 - ��'?6.$� <br /> Ownera Name 2 Z. Owner Phone Number � � - � <br /> Owners Address 3 Z"Jr� I—Re 1Ci G C� �- ��TTZ-�- Owner Phone Number� � <br /> Fee 3lmple Titleholder Name Owner Phone Number , <br /> Fee Stmple Titleholder Address <br /> JOB ADDRE33 ��Z sO r R.�°t��Zi t,�GS�a,� '%2 C �ZE'P�2 `ji/1 S �"L �3 3=��Z LOT# � <br /> SUBDIVISION Sl t i1 eP.,, �A KJ PARCEL ID# �� -��rZ'�Zad""" 000'�O 0 F� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT Q SIGN �] MOVE C] DEMOLISH <br /> INSTALL REPAIR <br /> PROP08ED USE [� SFR Q COMM Q OTHER <br /> TYPE OF CON3TRUCTION � BLOCK Q FRAME Q STEEL Q OTHER <br /> DE3CRIPTION OF WORK ���/k( � �� �% f"f.�� (R}, �,q �� �,q�� <br /> BUILDIN(3 SIZE SQ FOOTAGE HEIGHT <br /> � BUILDINO $ ����, �� <br /> VALUATION OF TOTAL CONSTRUCTION <br /> Q ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY [� W.R.E.C. <br /> Q PLUMBING $ <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION. � '�` � � � <br /> � GAS Q ROOFINO Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD 20NE AREA QYES QNO <br /> BUILDER C� � � d <br /> �s� COMPANY -�,e � <br /> SIGNATURE REGISTERED N FEE CURRENT Y/N <br /> Address � � � $� � '3 � O FL3Z$�7$ <br /> Ucense# ��'�.�' �S�� <br /> ELECTRICIAN COMPANY <br /> 81GNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address <br /> License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT . Y/N <br /> Address <br /> Ucense# <br /> MECHANICAL COMPANY <br /> SI.GNATURE <br /> REGISTERED Y/ N FEE CURRENT Y/N <br /> Address <br /> _ Ltcense# <br /> OTHER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ FEE CURR6N'r Y/N <br /> Address � <br /> l.icense# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)set of Energy Forms;R-O-W Permit for new constructlon, <br /> M(nimum ten(10)work��g days aRer submittal date. Required onsite,Construcdon Plans,Stormwater Plans w/Sflt Fence installed, <br /> Sanitary Factlitles&1 dumpster,Site Work Permit for subdtvisions/large projects <br /> COMMERCIAL Attach(3)sets of Butlding Plans;(1)set of Energy Forms.R-O-W Permit`for new construcdon. <br /> Minimum ten{40)worlc(ng tleys aftsr submitfal data. ReGu�rsrl onsite,ConsirucUon Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facflitles 8 1 dumpster.Site Work permit for all new projects.All commercial requirements must meet compllance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '"""PI�OPERTY SURVEY required for a8 NEW constructlon. <br /> Directions: <br /> Fill out applicatlon completely. <br /> Ovmer&Contractor stgn back of applicadon,nota�ized <br /> If over:2500,a Notice of Commencement is requi�ed. (A/C upgrades over a5000) <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 PERMITTING (Front of Application Only) <br /> Reroofs � Sewers Service Upgrades q/C <br /> Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways.,needs ROW <br />