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-- I <br /> ���y�i c.epnymi is Nermit Application Fax-813- � <br /> Buildin Department r <br /> � <br /> . Date Received •�) _( 9 ,7�,7 � �/ Y ��� ` <br /> �� � Phone Contact f r Permittin 1 <br /> Owner's Mame ���Tw�d� o G ��p h 'r h i 5 <br /> Oxrner �--g�'3'--QS"� <br /> �&3 3 ���� <br /> Oumers Address $y� - (,� Owner Phone Number <br /> Fr.e S�mqle Ti4leholder R!ame /V Oumer Phone Mumber <br /> Fee Slmple Titleholder Address N <br /> JOB ADORESS & ,33 � ' � � h r ` $ F � � LOT ti � <br /> SUODIVISIOM PARCE �ou ���- a6-�� - �aia -�,��, _�� <br /> (OBTAINED FR�OM PROPERTY TAX�NOTICE)DEMOLISH <br /> HUORK PROPOSED NEW CONS7R ADD/AL 0 SIGN <br /> B INSTALL REPAIR <br /> �=tovOSEU USE SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTIOtd BLOCK Q FRAME � STEEL Q <br /> DESCRIPTIOM OFlMORK � � �Q /{1�n J �j �Z'e CJ/Z V <br /> BUILDIFIG SIZE SQ FOOTAGE HEIGHT <br /> UILDING $ 1� ��Q` VALUATION F TOTAL CONSTRUCTION ( 6 <br /> ! <br /> (_�F!FC7RICAL $ AMP SERVI E � PROGRESS ENERGY O W.R.E.C. <br /> OPLUMBING $ �'� � / <br /> j �� � � <br /> QMECHANICAL $ VALUATION F MECHANICAL INSTALLATION <br /> tt�' ` � <br /> �GAS � ROOFING � SPECIA TY � OTHER � � r <br /> � �� <br /> FINISHED FLOOR ELEVATIONS FLOOD ONE AREA �YES NO �Q� �i JZ n�� <br /> P'/� �/1J1 " <br /> n6+aro Pt4 <br /> v <br /> BUILDER ��_^ ��� I J( CO PAMY /J M �� � <br /> SIGfdATURE `�/"'� RE STERED Y/ N FEE CURRE� Y/N <br /> Address �� �L �vGt� GC� S License# Q�SD�e� <br /> ELECTR�CIAfd CO PAMY <br /> SIGMATURE RE ISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> �LURfiBER CO PAMY <br /> SIGWATURE I � RE ISTERED Y/ N FEE CURRE� Y/'N <br /> Address License# <br /> MECHANICAL C fVIPANY <br /> SIGRIATURE RE ISTERED Y/ N FEE CURREI. Y/N <br /> Address License# <br /> py��EH C flAPAMY <br />' SIGfdATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDEtdTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)se of Energy Forms;R-O-W Permit for new construction, <br /> Mfnimum ten('10)working days after submittal date. equired onsite,Construclion Plans,Stortnwaler Plans w/Silt Fence installed, <br /> Sanitary Faellities&1 dumpster;Site Work Permit for ubdivislonsAarge projects <br /> COPoIfiAERCIAL Attach(3)complete sets of Building Plans plus a Life afety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)workfng days after submittal date, equlred onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster Site Work Permit for II new projects.Ail commercfal requirements must meet compliance <br /> SIG�pE�tAflIY Attach(2)sels ol Engineered Plans. <br /> ""PROPERTY SUftVEY required for all NEW constr ction. <br /> Directlons: <br /> Fill out applicatlon completely. <br /> Owner&Contractor sfgn back of application,notarized <br /> If over 52500,a Motice o(Commencement Is required. (A/C up redes over 57500) <br /> " Agent(tor lhe conVactor)or Power of Attomey(for the owner)would be someone with notarized letter from ovmer authorizing same <br /> OVER THE COUPITER PERMITTIMG (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgredes AlC Fenc (PIoUSurvey/Footage) <br /> DrivewaNs-Nol over Counler it on public roadways..needs ROW <br />