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���-�au-uuzu City ot[ephymiils Pe�mit Application ,��� ' �Lx-813-780-0021 <br /> �-�1� �� � uilding Department r-�r�� � C_41iYYu�z.�, <br /> , ��� v� <br /> Gate Rec6ived i'1 p . � -�n•,r.��,� <br /> d� Phone Contact for Permittin ` �j � � � <br /> Owner's Name `� . !f 1 <br /> Owner Phone Number <br /> Owner's Addresa � � ( <br /> Owner Phone Number <br /> Fee Simple Titleholder Name <br /> Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � �� <br /> LOT* � <br /> SUBDIVISION `� PARCEL IDM <br /> VMORK PROP03ED B (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NEW CONS7R 8 ADD/ALT � SIGN [� � DEMOUSH <br /> INSTALL REPAIR 1 <br /> PROPOSED USE �] SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION G <br /> [�,] BLOCK Q FRAME C� STEEL , <br /> DESCRIPTION OF WORK ��� �"�� '� C� <br /> . <br /> BUILDING SIZE Sp FOOTAGE� <br /> IGHT <br /> OBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE <br /> � Q PROGRESS ENERGY [� W.R.E.C. <br /> �'LUMBING a �� <br /> ��y <br /> QMECHANICAL a VALUATION OF MECHANICAL INSTALLATION r <br /> OGAS Q ROOFING Q SPECIALTY <br /> C] OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA <br /> QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas � <br /> License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � <br /> License# �— <br /> PLUMBER � � COMPANY �� , <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �( � <br /> License# t � <br /> MECHANICAL COMPANY CC �U �- � � <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> OTNER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREh Y/N <br /> Addreas <br /> 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 Plans w/Silt Fence installed, <br /> Sanitary Fadlitles&1 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 construction. <br /> Minimum ten(10)working days after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Faciflties&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Pians. <br /> '""'PROPERTY SURVEY required for all NEW constructlon. <br /> DI►ecHons: <br /> Fill out application compietely. <br /> Owner&Contractor sign back of applicatlon,notarized <br />*• If over 52500,a Notice of Commencement Is requtred. {A/C upgrades over 57500) <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 Appllcatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Oriveways-Not over Counter if on public roadways..need5 ROW <br />