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_._ ...,. ..,,_,. �,��y �i �epnyrnms rerm�t Hpp��cai�on Fax-813-780-0021 <br /> Building Departrnent <br /> Date Received 3 S �8 __ —]��3 <br /> Phone Contact for Permittin <br /> � <br /> O�nmer's Rlame C�� ('!�� �\Y� Owner Phone Mumber <br /> O�nmer's Alddress � � l Z \ ��l�(n� � a l Owner Phone(dumber <br /> Fee Simple Titleholder Mame ��l�M�'��- � Owner Phone Mumber <br /> Fee Simple Titleholder Address <br /> .DO�r4DDRESS �p �Z� � (Q ��� h r h���J F L•3 gs Z LOT# � <br /> SUBDINISIOM �(�r� ���` PARCEL ID# �Z'Zb Z� � d�80 • Q�QOQ 'Q�y('� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORCG P6tOPOSED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> �ROPOSED USE Q SFR Q COMM � OTHER <br /> Tl(PE OF CO(dSTRUCTlO(d �Q BLOCK Q FRAME 0 STEEL �] <br /> owtn� c o i....y� S <br /> IDESCRIPTIOM OF WORK �UC�`� �� rv�GrS'�p.�� �h�n � �ti� <br /> BUI�DIMG SIZE SQ FOOTAGE�� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION _ � � Z���Q� <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY �] W.R.E.C. <br /> OPLUMBING $ <br /> . /(��� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ` <br /> QGAS Q ROOFING SPECIALTY � OTHER -�°'e`� <br /> �1-�, <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES fV0 <br /> B1911LIDER 2 COMPe�NY <br /> SIGtd�1TURIE REGISTERED Y/ N FEE CURRE� Y/IV <br /> ����$S License# <br /> ELECTRICIAId COAAPA(dY <br /> SIGMATURE REGISTERED Y/ IV FEE CURRE� Y/N <br /> Address License# <br /> PLUIlA�ER COMPAtdY <br /> SIGR1i4TUIZE REGISTERED Y/ N FEE CURRE� Y/N <br /> e4ddress License# <br /> MECHAIdICAL COINOPANY <br /> 51GMQ►TURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ' License# <br /> OTHER wL.,,� COAlIPAMY <br /> SIGfdATURE I y�"8n REGISTERED Y/ N FEE CURRE� Y/N <br /> Elddress � � License# CCC��, Q�� <br /> R�SIDEtdTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W PeRnit for new construction, <br /> Minimum ten(10)wo�king days aRer submittal date. Requlred onsite,Constructfon Pians,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMIME9tC1AL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constriiction. <br /> Minimum ten(10)working days after submfttal 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 requirements must meet compiiance <br /> SIGfd PERiM1T Attach(2)sets of Engineered Plans. . <br /> "'"'PROPERTY SURVEY required for all NEW construcUon. � - <br /> Direct(ons: <br /> Fill out appl(cation completely. <br /> Owner 8 Contractor sign back of applicallon,notarized <br /> �• If over s2500,a fdotice of Commencement is required. (A!C upgrades over�7500) <br /> Agent(for the contractor)or Power of Attomey(far the owner)would be someone with notarized letter from ovmer authorizing same <br /> O!/�R TFIE COUNTER PERMIITTIfdG (Front of Applicatlon Only) <br /> Reroofs if shingles Sewers _ Service Upgrades A/C Fences(Plot/Survey/Footage) _ <br /> Driveways-Not over Counter,if on'public road'ways.:needs ROW .', �. ; <br /> ,: ' , t , , ', <br />