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a�s-7ao-oozo Cityot�epnyrnnis r�rn���hNN���a����� � <br /> Building Departmenf <br /> Date Received Phone Contact for Aermitting O�`3 7�• -- SJ� <br /> -iy-rry / - -I-I- <br /> Owner's Name q,7 �n C- �4� t° �f •�a" C`� -�'Owner Phone Number <br /> Owner's Address s� � �/ � � �- ' Owner Phone Number�— <br /> Fee Simple Titleholder Name • Owner Phone Nurriber� <br /> Fee Simple Titleholder Address ' ' <br /> JOB ADDRESS .�a�O ' ��� v L�T� �G 7 f <br /> . . <br /> SUBDIVISION ' • Qr Z l f PARCEL ID# l����°�'�JQO/D'^�J�C�r���1 v �c �/7 <br /> • (Of3TAINED FROM AROPERTY TAX NOTICE) <br /> WORK PROPOSED ' NEW CONSTR ADDlALT � SIGN � MOVE [� DEMOLISH <br /> � INSTALL e REPAIR <br /> PROPOSED USE' . 0 SFR ' [� • COMM � OTHER <br /> TYPE OF CONSTRUCTfON Q BLOCK [� FRAME ' .� STEEL 0 OTHER� —I <br /> DCSCRIPTION OF WORK ' r'e- (1�G� //��� �- ��' <br /> BUILDING SIZE ' S4�OOTAGE HL-IGFIT <br /> ' 0 BUILDING $ � fao� 0�' VALUATfON 01=TOTAL CONSTRUCTION <br /> 0 ELECTRICAL $ AMP SCRVICE � PROGRESS ENERGY 0 W.R.E.C, <br /> � PLUMBING � �������8�������� <br /> � (813)788-533� <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLAT(ON��,''�47��� <br /> . � . � 3� �f <br /> 0 GAS � ROOFING � SPECIALTY 0 OTHCR �� <br /> f=1NISHED FLOOR ELEVATIONS [=LOOD ZONE AREA DYES [�NO <br /> BUILDER C\ � � � `�'�� „ /_ _ ' � COMPANY U� � f � ' `�C - <br /> SIGNATURE �,�'�(�[-�—C�`-� e�e_S��v I� REGISTERED Y/ N FEE CURRENT Y/N <br /> Address �0 �y� /`'d�� ��n �"' � � " . License# <br /> ELECTRICIAN • COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Addres� � License# <br /> PLUMBER COM1'ANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# � <br /> MECHANICAL COMPANY , <br /> SIGNATURE • REGISTERED Y/ N FEE CURRENT Y/N . <br /> Address • • .License# <br /> OTHEF2 � COMPANY • <br /> SIGNAl'UR� RHGISTERED Y/ N FEE 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,Co�struction Plans•,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumps�er;5ite Worlc Permit for subdivisionsllarge projects <br /> COMMERCIAL Attacli(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-Q-W Permit for new construction. <br /> Minirnum ten(10)worlcing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary f-acilities&1 dumpster.Site UVorlc Permit for all new projecEs.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ****PF20PERTY SURVEY roquired for all NEW construction. • <br /> a-�-hH-Ff-Ii�-F�-�;;;;;;;;-t-;-H-�+H+h�a-ta-t-t-�a-��-��-���-�+Ft-H-ta-l-w-I+rHaa+rrrH-rt-�-la-t+t-l+t-E-r -i. :•• ., •:,•:••••'",•' <br /> Directions: <br /> Fill out application completely. • <br /> Owner&Contractor sign back of application,nofarized � <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$50D0) <br /> ** Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizfng same • <br /> OVER THE COUNTER PERMITTING (Front of Application Only) ' <br /> Reroofs Sewers Service.Upgrades A/C Pences(PfoUSurvey/Footage) <br /> 1]riveways-Not over Counter if on public roadways.:needs ROW <br />