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�.�ty v� c=cNny��i no rClllul H�,�JIICa❑Ofl F�x-813-780-0021 <br /> � Buttdi g Department � ' ' <br /> ,Date Re�elved -' 't,s :,,.::,y,..,,.:_ <br /> Phone Contact f r Permitting �..� G,�"�"�'Q `�'�. <br /> ,Qwner's Name � r a a` Owner Phone Number <br /> Owner's Address ,� �5�� � � r Owner Phone Numbe'r �� � <br /> Fee 8imple Titleholder Name Owner Fhone Numbe'r �Y � <br /> Fee Simple Titleholder Address <br /> JOB ADLIRESS � 7�O rn� LOT# �� <br /> suBaiv�s�arv V' �� l~�;1� � PARC�L Ib# Q�-��-a? - G/�d- �a a a o -- �/s'o <br /> (OHTA(NED FROM PROPERTY TAX NOTICEj <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN � � DEMOLISN <br /> INSTAL.Z REPAIFt <br /> ` PF20POSED USE � 5FR � GCiMM , � :OTHER - <br /> � TYPE OF GQNS7RUCTION � BLOGK C] FRANIE � STEEL Q <br /> i � . . .f4 , r '" '' ' 4 ., I � �.. _ .' F ' <br /> DESCRIP710NOFWOF2K ���ov: t� J� �1� o�a �it� �r J�11G <br /> BUtLDiNG SIZE � � SQ FOdTAGE " HEIGHT ���,_� - <br /> �BUILDING � �LjJ�� VALUATION F TQTAI.CONSTRUCTION , <br /> l 6r <br /> � �� AtvfP SERVIC � PftOGRESS ENERGY � W.R.E.C. <br /> ELECTRICAI. $ ...—...-- <br /> �PLUMBiRlG $ C� <br /> ��� , : ��� <br /> OMECHANlGAl.. $ VALUATION 11+iEGHANlCAI:.1NSiALlATION �` <br /> I <br /> OGAS 0 ROOF(NG 0 SPECIAL Y � t7TNER <br /> FlNISNED Fl.00R E�EVATIONS � FLOOD Z PIE AF2EA �YES NO <br /> � <br /> � // 7 �-�- <br /> BUiLDEi2 s�,, CO1N ANY '��� ot,,/ -+�'`��r/ u� �� �I' � <br /> SlGNATURE REGiS ERED Y N FEE CURREt� /N <br /> Address 0 /'.�'s�in/I� � ' License# ..��G ���f'� <br /> Ei.ECTRiCtAN COM ANY ' <br /> SlGNA3llRE REGtS ERECI —�.Y I N �EE Ci1RREh Y I N <br /> Address Llcense# � �. <br /> PLUMBEi2 COM ANY � <br /> SIGNAiUF2E �e�is �t�e� Y! N FEE CURREh Y I N <br /> Address License# �-- � <br /> MEGHANICAL COM ANY <br /> SlGNATURE. ReGJS EReo Y( N. FEE CURRER Y I N <br /> Address License# � � <br /> OTHER �� caM ANY <br /> SIGNATURE f?eGls ERED Y 1 N FEE CURREh Y t PJ <br /> Address License# �� � <br /> RESiDENTtAI. Attach{2)Plat PEans;(2)sets of Build'+ng Plans;.(1j set`bf nergy Forms;Ft-O-W Permit for new consiruction, <br /> Minirrium ten(1�)working days aEter submittal date. Requ red onslte,Canstruclion Plans,Starrnwater Pians wi Siit Fence insta!led, <br /> Sanitery Facilities 8�1 dumpster;Sike Work Permit far sub ivisions/large projects <br /> GOMMERClAL Attach(3}complete sefs of Building Plans plus a LiFe Safe y Page;(1}set af Energy Forms.R-O-W P'ermit for new canstructlon. <br /> Minimum ten{10)working c�ays after submittaf dafe. Requ rzd onsife,-Construction Pians,StormwatecPVans w!Siit Fence"instaited, _ - <br /> Sanitary Facilities& 1 dumpster.Site Wark Permit fo�all n w projects.All commerciai requirements must meet compliance <br /> SiGN PERMII' Atfach(2}se#s of Engfineered Pians. <br /> *`"'*PROPERTY SURVEY required€or aii NEW oonstructio . <br /> Directions: <br /> Fi}!out appfication campletely. <br /> Owner&Contractor sign back of application,natarized <br /> if over$2500,a Notice af Commencement is required. (A/C upgrad s over$7500) <br /> ** Agent(for the contractor)or Power of A#torney(for the owner)would be s meone with notarized letter from owner authorizing same <br /> OVER TNE CQLlNTER PERMITTiNG (FronE of Appiication Only} <br /> Raroofs if shingies Sewers Service Upgrades AtG �ences{Pi ttSutveyiFootage} <br /> Driveways-Not over Counter if an public roadways..needs ROW � <br />