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s13-7so-ao2o City ot�epnyrnn►s r�rnu�r�NN���a����� . <br /> ' Building Deparfinenf <br /> Date Received �� �� phone Confact for Aermitting a�� �� . -- ��� <br /> -myy -rrrri-rr► <br /> Owner's Name ��-�`"/J rC./� /�-l�aL�(Q/� • Owner Phone Number � � <br /> Owner's Address so�s� s�� fTCP�T. • Owner Phone Number[ <br /> Fee Simple Titleholder Name • Owner Phone Nurriber[ <br /> Fee 5imple Titleholder Address ' ' � <br /> JOB ADDRESS S cZSI �5��J /�-e � ' � LOT� ��` �� <br /> SUBDIVISION . � Ze �/�1 PARCEL ID# /l—°L6—°��� 0�/d �/,,�� (f- QO�� <br /> • (O�TAINED FROM PROPERTY TAX NOTIC[) <br /> WORK PROPOSED ' NEW CONSTR ADD/ALT 0 SIGN � NIOVE Q DEMOLISH <br /> � INSTALL e REPAIR <br /> PROPOSED USE' • � SFR ' � • COMM � OTHER � <br /> TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME � .0 STEEL � O�THER <br /> DCSCRIPTION OF WORK C�,��; � /`�(�r�� `�� �„� � ,/G7 `�i EI `� ��Y� � <br /> BUILDING SIZE `Q X J 7 SQ 1=00TAGE �Y � HEfGHT C� <br /> ' � BUILDING $ (�`� O�vt Cl� VALUATION OF TOTAL CONSTRUCTION <br /> / W <br /> � ELECTRICAL � AMP SCRVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> 0 PLUMBING $ �������8�����,/��� <br /> (813)788-53��€ <br /> � VALUATION OF MECHANICAL INSTALLATION��1�-�24�7�4� <br /> MECHANICAL $ <br /> ��,�Z zI <br /> 0 GAS 0 ROOFING � SPECIALTY � OTHCR <br /> �INISHED FLOOR ELEVATIONS �I �LOOD ZONE AREA [�YES []NO <br /> � <br /> c���.��/; . /'Y�/�L�U ' 1.�'�,' COMPANY �Ct/1 � �7� �� • _.T/1C . <br /> BUILDER E' <br /> SIGNATURE ��-�� F2CGISTERED Y/ N FEE CUI�RENT Y J N <br /> Address � �S� Q�� �« � r' `l � ' ' . License# <br /> ELECTRICIAN �� � � COMPANY <br /> SIGNATURE I �� ��' � REGISTERED Y/ N FEE CURRENT Y/N <br /> Addres� • � License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> � `- �(c�� ` � •Q <br /> MECHANICAL COMPANY , <br /> SIGNATURE REGISTERED Y/ N FEE URRENT Y/N <br /> Address yyyl /L � � � ' .License# _� <br /> OTHER � COMPANY ' <br /> SIGNA'I'URE RCGISTERED � Y/ N PEE CURRENT Y/N <br /> Address License# <br /> RESID�NTIAL Attach(2)Plof Plans;(2)sets of Building Plans;(1)set of Cnergy Forms;R-O-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 Worlc Permit for subdivisions/large projects <br /> COMMERCIAL Attacli(3)complete sets of Building Plans plys a Life Safety Page;(1)set of Energy Forms.R-O-W'Permit for new construction. <br /> Minimum ten(10)worlcing days affer submittal date. Required onsite,Consfruction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary f-acilifies&9 dumpsfer.Site Worl<Perm(t for all new projects.All commercial requiremente�must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '***PROPERTY SURVEY roquired for ali NEW construction. � <br /> -I-FFi-�+►a+f-f-�-f-ri-H+I-w-►-f-H-rH-1+H-r�-Hi-H-1-I-1-{-Hi-�-1-1-h►-H-I+H-FH-rI-�+I+Ft-l-1-1-H-1+►-}-I-f-Ia-I-I-H-l-1-H-�-r1+H+i-t-1-M-i°1-f-i;;-i-f-4-�;-H-H-i-1-1-ti-i- ' . ,,� <br /> Directions: , <br /> Fill out application completely. ' <br /> Owner&Con(ractor sign back of application,notarized ' <br /> If over$2500,a Notice of Commencement is required. (AlC upgrades over$5000) <br /> ** Agent(for the contractor)or Power of P;ttorney(for the owner)would be someone wifh notarized letter from owner authorizing same - <br /> OVCR THE COUNTER PERMITTING (Front of Application Only) ' <br /> Reroofs Sewers Service.Upgrades A/C Pences(PlotlSurvey/Footage) - <br /> Qriveways-Not over Counter if on public roadways.:needs ROW <br />