Laserfiche WebLink
�'�-'°�-�u�� t;iry ot�ephymilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin ' � __ � � <br /> Owner's Name � � � c _(_ /._ <br /> C .�'S Owner Phone Number �.v <br /> Owner's Address L.% � C� i i, Owner Phone Number � <br /> Fee Simpie Titleholder Name anrner Phone Number <br /> Fee Simple Titleholder Addresa <br /> � � � � <br /> JOB ADDRESS " c <br /> �' LOT N �j��02 I � <br /> SUBDIVISION � � PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> 1NORK PROPOSED B NEW CONSTR� ADD/ALT �� SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK ' Y�(�� ��y� ,� e�.- �/1/in <br /> BUILDING SIZE SQ FOOTAGE HEIGHT �� <br /> �` <br /> BUILDING a 0'� ,r^yr-y � VALUATION OF TOTAL CONSTRUCTION �� 3�3� <br /> C�CC �� <br /> QELECTRICAL S AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUM8ING a <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION !` �r ��� 3� <br /> � �� t� <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER `� .� � <br /> �� ��� s���� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO n�,� � <br /> l� <br /> .� 1 <br /> C <br /> BUILDER MPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas � � L n # <br /> ELECTRICIAN � - J <br /> �• COMPANY �. �' � �. <br /> SIGNATURE ii/ " REGISTERED Y/ N FE CURRE� Y/N <br /> Address � � , '�- �� y(�,{�� License# � —, <br /> � <br /> i � �� <br /> PLUMBER �' ,�r ��L t L � �COMPANY � c ( �� <br /> SIGNATURE � REGISTERED Y/ N FE URRE� Y/N <br /> Addreas �� f � � ���L(->L°y License# �� �� �- <br /> IIAECHANICAL }� COMPANY /— �,� _�'� � <br /> SIGNATURE v' REGISTERED Y/ N /FEE CURRE� Y/N , <br /> Address r L- 3�j�� License# � �� l �`1 �� � <br /> OTHER � , �, COMPANY �J � S� ` �i C ��S� l �JyC <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 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,Stormwater P�ans w!Silt Fence installed, <br /> Sanitary Fadlitles�1 dumpster;Site Work Permit for subdivisionsAarge 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)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facflities 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compllance <br /> 31GN PERMIT Attach(2)sets of Engineered Plans. <br /> '•"PROPERTY SURVEY required for all NEW constructlon. <br /> DirecHons: <br /> Fill out applicallon completely. <br /> Owner 8 Contractor sign back of applicatlon,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgradea over 57500) <br /> '• Agent(for the conVactor)or Power of Aftomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PBBMITTING (Front of AppilcaUon Only) <br /> Reroofs if shingles Sswers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Oriveways-Not over Gounter if on public roadways..needs ROW <br />