|
o,o-rov-wcv c;�ry or�epnyrn��s Perm€t Applicatian F�x-813-780-4021
<br /> Buildin Department
<br /> Date Received hone Contact for Pennittin --
<br /> ,
<br /> P
<br /> Dwner's Name � c��` �C��LT~u- � Qwner Phone Number
<br /> Dwne�s Address ���? 7�+ �'�/'���� Owner Phone Number � �
<br /> Fce Simpte TiNeholder Name �� _� Uwner Phane tdumber �— �
<br /> Fee SEmpte T3tleholder Address :.
<br /> � . *
<br /> �as aoo��ss �'6�� ���i��'� �o�r# C_�
<br /> _su�Qrns�o�r ��1� t�tyL/12G�� Pa[tCEL D� �c�:S~�S Zf�-- d 1,S°� ��Q4Q �- �.�
<br /> �-___--- �_�. _ ____--- _ — _--- - ---- -- _ _ _.�
<br /> '_ --`(061TP+INEDFROAAPROPERTYTAXNOTICE)' - -'-- �" - —
<br /> WORK PROPOSED [� New ca�vsrR� _ADD/AL7 [� SIGN [� � DEMOLiSH
<br /> (� INSTAII. r(�'"' FtEPA1R
<br /> PROPOSED USE Q SFR Q COMM �+ OTHER
<br /> i1fPE OF COFiS7RUCTtt�ld Q BLOCiC [] FRAME :"� STEEL Q
<br /> oESC�rPTtaH a�woR�t 12d�,s-'jn1G' f� �./� r�GL ff.t/ 5�.;.� 1�S
<br /> BUILDlNG SlZE � � SQ FOOTAGE�?1 FlEIGNT C�_��
<br /> CJBUILDING $ '�-•� yALUATit?N F TOTAl.CONSTRUCTEON
<br /> a � � � _
<br /> QELECTRICAL �i � AMP SERVICE -�] PROGRESS ENERGY [� W.R,E.C.
<br /> QPLUM8ING ���� � �� +�l�
<br /> . � ��
<br /> OMECHANICAL $ VALUATION F MECHANICAI.WSTAI,IATIOM ,
<br /> QGAS �~ ROOFING Q SPECIAL � 07HER
<br /> =1NiSNED FLOOFt EIEVATtONS FLOOD ZC1NE AREA QYES NO �,
<br /> 3UILDER COMPANY
<br /> StGNATURE R�cs irEttea Y! N FEE CUR12E� Y/N
<br /> Address license# � `� �
<br /> cI.ECTRIG1AId COM�PANY
<br /> 3ICaNAT11RE REGt TERED Y I Itif FEE CURREA Y/N _
<br /> Address 1 �icense# �� ��
<br /> �LUMBER GOMPANY
<br /> 3EGNATURE REGI 7ERED Y t N FEE Cl1RREi� Y 1 N
<br /> Address License# �— � �
<br /> AECHANICAL COMPANY
<br /> 31GNATUFtE � REGi TERED Y I 1+! FEE CURREE Y 1{V
<br /> �
<br /> Address � Ucense# r� �
<br /> )THER � ���_ CO ANY U`"��1� �(����
<br /> ilGNATURE REG! TERED � Y 1 N FEE cu�zREt+ Y!N
<br /> Address � �� ��3 U��C�z` �G-: � , License# ��-D��p,��� �
<br /> tESIDENTIAL Attach(2)Plat Plans;(2)sets of Building Plans;(1)set of Energy Farms;R-O-W Permit for new consUuctlon,
<br /> Minimum ten{10)watking days after'submittai.date. Req Ited onsits,Constnaa#ion Plans,Siormwater P1ans wl 8ilt Fence installed,
<br /> Sanitary Facllities&1 dumpster,Site Work Pertnit for su divistonsAarge projects
<br /> :OMMERCIAL Attach(3)complete sets of Building Plans plus a Life Saf ty Page;(1)set of Energy Forms.R-O-W Permtk for new construction.
<br /> Min{mum ten{10}wark;ng days after submittai da#e. Req ired ansite,Gans#ruetion Pians,Stormwa�ter Plans wJ Sit#Fence 3nstalled,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit for ail�ew projecks.Aii cammercial requirements must meef complfance
<br /> i1GN PEFCMIT Attach(2)sets of Engineered Plans:
<br /> ""PRQPERTY SURVEY required far alt NEW construcU n..
<br /> iirectlons: �
<br /> Flli out applicatian camptetely. .
<br /> Ovmer&Contractor sign back of appllcation,notartzed
<br /> If over y2500,a Notice of Commencement Is required. (AIC upgra es over$7500)
<br /> ' Agent(for fhe c�ntractor}or Power of Attomey(for the awner)would be ameone wtth notarized te#er from owner authorizing:same
<br /> IVER THE COUNTER PERMITTING�_ � =(Front_af-AppUcatlon Onlyj�.;.,.,; . ,4 ,.¢-�.�=.�,..--:�.��..�..�..,..,�..K..,,....:, .,.,-..�,... .,.
<br /> :eroofs if shingles Sewers ,; Setvtce Upgcades'AlG ;,-Fen�es:{ IotlBurreyJFootage) ; . � , '�
<br /> Driveways-Not over Counter.if..on pubAcroadways,:needs ROW::_�:�� � a ., � , - '' , ' - . ?
<br /> r> . _, ..�n <:r*.� a.,..:�F�..x N, .,.s..:�:"..,.:� :�- .�.. � ���, .. . ,.,��u,z ..v,. . .. „..' ;
<br />
|