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, s��-�so-oozo ills Permit Application Fax-813780-0021 <br /> Buil rtment <br /> ��°R°°�� Phone CaMad for n� � �y J <br /> � � � � � <br /> Ownsr's N e � �'t' Y qwnsr Phona Mumber V <br /> Owne�,.s Addrsss . �� , S]lJ...� �„l"�— Ownsr Phone Numbsr - <br /> % <br /> Fee�imple Titleholder Name Ow�r Phon�Numbsr <br /> Fe�i SImpN Titlehdd�r AdM�ss <br /> JO ADDRE85 � � LOT/ � <br /> SU N vi PARCEL IDA —5�d — �' I'l - wU�'" I� Q <br /> --_._______----.----� pti ����.�K„-T�►a„�, <br /> WORK PROPOSED B NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR ,r <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> `� <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q /-��,y� -� <br /> ��4 <br /> DESCRIPTION OF WORK � S �� � � <br /> BUILDIN6 SIZE ���S�Y � SQ FOOTAOE 1y� HEIOHT � ��� �G6� <br /> ����� <br /> QBUILDINO S �(�l. VALUATIONOFGTALCONSTRUCTION �pf �� 1Pa <br /> c ')._,�� „ (� a <br /> QELECTRICAL S ` f. AMP SERVICE 4 Q PROGRESS ENERGY Q W.R.E.C. '�`�"°-- <br /> l � !� <br /> OPLUMBING s �1�,� } ��j <br /> � �' (. <br /> QMECHANICAL $ �� VALUATION OF MECHANICAL INSTALLATION ��y����� <br /> � �- _ <br /> QGAS ROOFING Q SPECIALTY Q OTHER P <br /> FINISHED FLOOR ELEVATIONS FIOOD ZONE AREA QYES NO ���'�5 <br /> BUILDER � PANY 1-"1\� �1�� �ArL.I_��1 CTU lJ ��e��� <br /> �G�T�� r�a Y/N FEE cu2�En Y/N LL(_ <br /> nearass 3 J-�3 uoenae# _ <br /> ELECTRIC COMPANY ""V " � �1J��n G�C��� <br /> $IC3NATU REGISTERED N FEE CURRE� Y/N j <br /> ��.. 33S3 ���,ee� �� or�t�ac-�u <br /> PLUMBER ��PANY � 'L �1�- �ku� <br /> SKiNATURE �dsrEllE� Y/ N FEE CURRE� Y/N (�[�V <br /> Address ' f I ��# <br /> MECHAN COMPANY � 1 1) `—� � � �E� <br /> SItiNA7U E rtEG157EREO Y/ N FEE CURREI. Y!N <br /> ,�d�. , � , �Je. ��,�# c_. �P� <br /> on+� � COMPANY � ���b` �I� <br /> 81GNATURE r�a�srE�o Y/ N fEE CURRFJ. Y!N <br /> Addrsas License# � � <br /> RESIDENTI/1L Attach(2)Plol Planc;(2)sets oi Building Plana:(1)set ot Energy Forms;R-O-W Permit fa new construcUon, <br /> Minimum ten(10)working deys after submilta�date, Required onsite,Conslruction Plans,Stormwater Plans w/Sitt Fence instelled, <br /> SaMtary Facilities 8 1 dumpster;Site Work Permit fa subdlvisionsAaarge projeds <br /> COMMERCUIL Atteeh(3)complete sets oi Building Plans plus a Life Sefety Page;(1)set M Enargy Forms.R-O-W Pertntt for new construclion. <br /> Minimum ten(10)working days after submittal date. Requked ansite,ConsWction Plans,Startrvvater Plans w!Silt Fence inst�led, <br /> Sanitary Fecilifies$1 dumpster.Site Work PermR far all new projects.All commerdal requirements must meet compNance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '""PROPERTY SURVEY required fa all NEW conatruction. <br /> DlncUons: <br /> Fill out application completey. <br /> Owner 8 ConVactor sign beck of applicetbn,notarfzed <br /> M over 52500,a Notfce ot Comms�e�meM b requlrod. (MC upgradss owr 57500) <br /> "' Agent(fw the contractw)w Power of Attomey(for the oNmer)would be someone with notarized letter from oMmer authorizing same <br /> OVER TNE COUNTER PERMfTTiNO (Front of Applicsdon Onty) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/SurveylFootage) <br /> Driveways-Not over Counter if on pudic roedways..needs ROW <br />