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' - "'" ""`" .,.ny �� ��pnymins rermit Hppncation Fax-813J80-0021 <br /> Building Department <br /> DaYe Received Phone Contact for Permittin � ���� <br /> Owner's Name ��(% �.�- Owner Phone Number <br /> Ovmer's Address ��� • � c� � L . �� � Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number [ <br /> Fee Simple Titlehoider Addresa � <br /> JOB ADDRESS 3�} L.�� �"L�-(,� �,�. �j�� � ���C' �� � � <br /> � -1s?��_ LOT# <br /> SUBDII/ISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> bVORK PROPOSED NEW CONSTR ADD/ALT SIGN Q Q DEMOLISH <br /> INSTALL 8 REPAIR � � �,� <br /> PROPOSED USE Q SFR � COMM �� OTHER � <br /> 1fYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �� ` � �,/l �(�, � � J ,�� ,e c? ►S �; <br /> C� <br /> BUILDING SIZE � SQ FOOTAGEC� HEIGHT ����jl��� (,�_� <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> '13 ,,�, - <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL � VALUATION OF MECHANICAL INSTALLATION ���"1�� � <br /> QGAS �\ ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGtVATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C -� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Address License t� C � <br /> PLUMBER � COMPANY <br /> SIGNATURE REGISTEREO Y/ N FEE CURRE� Y/N <br /> Addreas License# C <br /> MECHANiCAL COMPANY <br /> SIGNATURE "�EGISTERED Y/ N FEE CURRE� Y/N <br /> Address +► License# C <br /> OTHER (����� COMPANY �'Y �u� �1�C�'' `� <br /> SIGNATURE �--T�� � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �► .�.-�� S�I 2� c♦ 1� ����-�� License# �5�, I � � 7(..J� <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum ten(10)working days after submittai date. Requ(red onsite,Constructfon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliHes&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)camplete sets of Buflding 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 Facilities 8 1 dumpster.Site Work Permit for all new projects.All commercial requiremen�must meet compliance <br /> SIGM PERMIT Attach(2)sets of Engineered Plans. <br /> •'"•PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notaNzed <br /> If over s2500,a Notice of Commencement is requfred. (A/C upgrades over ST500) <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 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 />