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. ." �'""" �.Ily VI G��►lyff11115 YefRlli HP�.111C8[IOrI Fax-813-780-0021 <br /> Building Department <br /> Date Received //— �� _, <br /> Phone Co�tact for Permittln <br /> Owner's Name -I/t/t G �f l/ti�s Owner Phone Numb �f 3' � �j���� 7S <br /> Owner's Address � 97� � ST �/� Z�/✓� /j�liL� � P ._ <br /> Fee Simple Titleholder Name C�'y"� / , <br /> Owner Phone Number �p � � <br /> Fee Simple Titleholder Addresa <br /> JOB ADDRESS 3 !YP�✓ %�✓D' Y� Zl�,�,�yn��c�s �L LOT# /1�/� <br /> SUBDIMISION PARCEL ID* � - 7i�o ' Z I '' lN O t �{���(�()l� <br /> (OBTAINED F�pROPERTY TO rice)DEMOLISH <br /> 1NORK PROPOSED � NE ONSTR AD /ALT � SIGN <br /> TALL q <br /> PROPOSED USE � SFR Q COMM �� OTHER <br /> �YPE OF CONSTRUCTION Q BLOCK �] FRAME �� STEEL [� ----, <br /> DESCRIPTION OF WORK JZ� f� �� � � /�y��C,,�L �y ���p ���fa� LO /� � �C <br /> BUILDING SIZE —� gQ FOOTAGE U HEIGHT <br /> QBUILDING $ VALUATION OF�L ONSTRUCTION <br /> , l <br /> QELECTRICAL $ ' A SE ICE Q PROGRESS ENERGY Q yy.R,E;�; <br /> _G% °�—� oa <br /> QPLUMBING a � <br /> �� �X I' S`d�d ��r-�( � <br /> ��� �`'r''�. 1 Sz �3, �7 � <br /> OMECHANICAL a VALUATION OF MECHANICAL IN TION <br /> OGAS Q ROOFING Q SPECIALTY [�] OTHER � (�� �� <br /> FINISHED FLOOR ELEVATIONS �� /�`�� FLOOD ZONE AREA QYES � '� � <br /> w c�1 <br /> BUI�DER ! � "��'r � COMPANY " � <br /> SIGMATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# —� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address l.icense# <br /> PLUMBER � COMPANY <br /> SIGNATURE REGISTEREO Y/ N FEE CURREA Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGMATURE REGISTERED Y/ N FEE CURRE� Y I 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 Buflding Plans;(1)set of Energy Forms;R-O-W Pennit for new construction, <br /> Minimum ten(10)woricing days after submittal date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaclflNes 8 1 dumpster;Site Work Permit for subdivisionsllarge 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 construction. <br /> Minimum ten(10)wotking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliUes&1 dumpster.Site Wor1c Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "'""PROPERTY SURVEY required for all NEW constructlon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sfgn back of applicatlon,notar(zed <br /> If over:2500,a Notice of Commencement ia requlred. (A/C upgrades over ET500) <br /> "• Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> 01/ER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />