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oi�-iau-uucu c;iry ot�ephymills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Datb Received <br /> Phone Contact for Permittin __ ��L <br /> Owne►'s Name �i�l �u.l,Y � Owner Phone Number .�p�• (p��� <br /> Owner's Address Owner Phone Number -� <br /> Fee Simple Titleholder Name Owner Phone Number �- <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS '1 �4P • �l r�. �S�-� (� LOT* �J 9 � <br /> SUBDIVISION fl''(,�q ��(,�Q(`P� � PARCEL ID� J•ca�f •�S�'}' � �-�OOO . I � 9(� <br /> (OBTAINED FROM pROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONS7R 8 ADD/ALT � SIG� ^ - ^Q Q DEMOIISH <br /> INSTALL REPAIR <br /> �e -�.uc�-�- <br /> PROPOSEO USE � SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION �f BLOCK Q FRAME �� STEEL Q <br /> DE3CRIPTION OF WORK � .�� � � � --r` C_.�t <br /> BUILDIN(i SIZE SQ FOOTAGE C] HEIGHT <br /> �BUILDING S � VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL a AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING a <br /> 3��� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> OGAS �� ROOFING Q SPECIALTY C] OTHER � �� 3 <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License t� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> 31GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address license# �- <br /> OTHER COMPANY � � <br /> SIGNATURE � REGISTERED Y/ N FEE CUR Y!N <br /> Address � License# �•L•�� �� � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pem►it for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Ptans w/Silt Fence instalied, <br /> Sanitary Fadlitles&1 dumpster,Site Work Permit br subdivisi�s/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safey Page;(1)set of Energy Forms.R-O-W Permit for new constructlon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY requlred for all NEW constructlon. <br /> Directlons: <br /> Fill out applicatlon oompletely. <br /> Owner&Contractor sign back of appliqtlon,notarized <br /> If over i2500,a Notice of Commencement is requlrod. (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 Applicatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlobSurvey/Footage) <br /> Drivewaya-Not over Counter if on public roadways..needs ROW <br />