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-•- -- ---� �.,��y �� �cpnymnis rermi�Hppncat�on Fax-813J80-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin -- <br /> Owner's Name � �� ����1 Owner Phone Number <br /> Owner's Address �� c..�� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titlehoider Addresa <br /> JOB ADDRESS ��� � �� � <br /> I.OT# <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> bVORK PROPOSED NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTNER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK � v'��� �V � ""� �c� `�'yt�( <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING � VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ �Q O ��� AMP SERVICE ��Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL � VALUATION OF MECHANICAL INSTALLATION �/�� <br /> � � <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FtNISHED FLOOR ELEVATIONS � FLOOD ZONE AREA DYES NO <br /> BUILDER COMPANY <br /> SIGMATURE REGISTERED Y! N FEE CURRE� Y J N <br /> Add�ess License# � <br /> ELECTRICIAN ( ) COMPANY /�`/`�� CC �( �—' C"C <br /> SIGNATURE �"` v�bc� REGISTERED Y/ N FEE CURREP Y/N <br /> Address �l L � �Z°ci;,�' �z License# �� — �� v+2.`>' 7C7 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets oi Building Plans;(1)set of Energy Forms;R-O-W Pe►mit for new construction, <br /> Minimum te�(10)working days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FadliNes 8 1 dumpster;Site Work Petmit 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 construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciBties 8 1 dumpster.Site Work Permit for all new projects.All commercia�requirements must meet campliance <br /> SIGN PERAl11T Attach(2)sets of Engineered Plans. <br /> •'•"PROPERTY SURVEY required for atl NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of applicaUon,notarized <br /> if over i2500,a Notice of Commencement is roqulred. (A/C upgrades over i7500) <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 Apptication Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurveylFootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />