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o io-iau-wcu c;iry ot�ephymills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received � Phone Contact for Permittin � -. <br /> Owner's Nam Owner Phone Number "'� <br /> Owner's Address Owner Phone Number �� i� � <br /> Fee Simple Titlehoider Name Owner Phone Number r� � <br /> Fee Simple Titlehoider Addresa y, <br /> J08 ADDRESS LOT� QO <br /> SUBDIVISION t -� / <br /> ARCELID�! �-- l�iQ - Z-�-U� Z I,3' - (�SD� �Q�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP03ED NEW CONSTR AD LT � SIGN Q [� DEMOLISH <br /> B INSTALL � � PAIR <br /> PROPOSED USE Q SFR Q COMM [� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL � <br /> DESCRIPTION OF WORK f� <br /> BUILDIN(3 SIZE SQ FOOTAG �j1' HEI(iHT <br /> �BUILDING � <br /> / •--- �VALUATION OF TOTAL CONSTRUCTION <br /> r:` a <br /> QELECTRICAL � �� AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING a 3���0 <br /> OMECHANICAL S VALUATION OF MECHANICAL INSTALLATION �� <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FIOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER �� COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �� <br /> License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Lfcense# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r <br /> OTHER COMPANY <br /> SIGNATURE REGISTEREO Y/ N FEE CURRE� Y J N <br /> Addrosa License# <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,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Fadlities 81 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon. <br /> Minimum ten(10)workfng days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence lnstalled, <br /> Sanitary Facflities 8 1 dumpster.S(te Woric Permit for all new projects.All commercfal requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> •"'"PROPERTY SURVEY required for all NEW constructlon. <br /> Oirections: <br /> Fill out application oompletely. <br /> Owner b Contractor sign back of appliption,notarized <br /> If over S2S00,a Notice of Commencement is required. (AIC upg►ades over 57500) <br /> '• Agent(for the contractor)or Power of Attomey(for the owner)would be someone with nota�ized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of AppHcaUon Only) <br /> Reroofs if shingles Sewers .ServicelJPB[ades A/C Fences(Plof/Survey/Footage) <br /> Drivewaya-Not over Counter if on public roacNvays..needs ROW. _,, „ • - <br /> d , <br /> . � , . <br /> 1l.:,..r.,.. a. . _. . . <br />