Laserfiche WebLink
�— 813-780-0020 . Clh/Of Z@pFtyrl'l1llls Permit Application Fax-813-780-0021 <br /> Buildin Department <br /> Date Received Phone Contact foq Permittin O �� �a2. — DL . <br /> � /� S13�- '7b'0 ��ll, <br /> Owner's Name � L 7I�j� Owner Phone fdumber <br /> Obmer's Address (O� �G �T..� r/�/l1� f}- Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS CQ D a� � � /� � __-�----- - — LOT# �� <br /> SUBDIVISION PARCEL ID# v�! oCIQ � ���� BD�Dd d 1'�6[! <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> 1�lORK PROPOSED e NEW CONSTR� ADD/AL � SIGN 0 � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> 7YPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK ��/�r.1/I� 9t/�E (,�L�� c3L �a T�/'Y) ° d�l� � S � /1�C�J�I � <br /> � <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION � F TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVIC Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ O� <br /> l5� <br /> QMECHANICAL $ ��Q�` � VALUATION F MECHANICAL INSTALLATION �( <br /> d <br /> OGAS Q ROOFING Q SPECIA TY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD�ONE AREA QYES NO <br /> BUILDER CO PANY <br /> SIGNATURE REG STERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN CO PANY <br /> SIGNATURE REG STERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER CO PANY <br /> SIGNATURE REG STERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICA � �- � CO PANY 61f*E�R S /� H/lI�CSfts�j�N. <br /> SIGfdATURE � Re ISTERED Y/ N FEE CURRE� Y/N <br /> Address ��'�7�� �6 �0� � ��/� �� �3 �� License# L/T�=-0 '���� � <br /> OTHER CO PANY <br /> SIGNATURE RE IsrertE� Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDEfdTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set f Energy Forms;R-O-W Permit for new construcdon, <br /> Minimum ten(10)working days after submittal date. R qufred onsite,Construction Plans,Stormwater Plans w/Siit Fence instalied, <br /> Sanitary Facilities 8�1 dumpster,Site Work Permit for s bdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Buildfng Plans plus a Life S fety Page;(1)set of Energy Forms.R-O-W Permit for new construct(on. <br /> Minimum ten(10)working days after submittal date. R qulred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> San(tary Facilities&1 dumpster.Site Work Permit for a I new projects.All commercial requirements must meet compUance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW constru Uon. � ' <br /> Directions: <br /> Fill out application completely. <br /> Ovmer&Contractor sign back of applicaUon,notarized <br /> If over 52500.a Notice of Commencement is requlred. (A/C upgrades over y7500) <br /> •• Agent(for the contractor)or Power of Attomey(for the owner)would e someone with notarized letter from owner authorizing same <br /> O!!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 />