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_._ .__ ____ ti.,��y or�epnymins rermit Appiicatian Fax-813-�$o-oazl <br /> BuRding Deparhssent <br /> Date Reeeived , - Phone Contact for Permltttn - <br /> Qwner's I�ame �'t� . �p� � Owner Phone Namber ,_i_„� <br /> pwners Address �7�CJ � � �''"� dwner Phone Namber �� � I <br /> Fee Simpie Titlehoider Name � � Ou+mer Phon�Number �� � <br /> Fee Slmple 7ltleholder Address <br /> JOB ADDRESS �C� ,,,,SC� ,��'7� y.^- LOT# �� <br /> SUBDNISION �— � PARCEL!'0� <br /> (OBTAINED FROM PROPERTY TAX NQTICE) _� � <br /> _ WORK-PROPOSED� NEW CONSTa- �ADD/AC'P-"� ` SIGN Q [� dEMOUSH <br /> ^�e.' =_ INSTAII 8 REPAIR <br /> PRQPOSED USE [� SFR [� CORdM z� OTHER <br /> t'YPE OF CONSTRUCTION Q BLOCK [� FRAME � STEEL Q <br /> DESCRtPTiON OF WORK `��- � ��+�'� <br /> BUIL.DING SIZE � � SQ FOQTAGEC_�� liE1GHT, ��� <br /> OBUILDING $ .� VAI.UA710N OF TOTAl.CONSTRUCTlON <br /> [�I.EC7RICAL. $ �5.�` ,,,,,,� AMP SERVICE �Dc� [� PROGRESS ENERGY [� W.R.E.C. <br /> 7-- � - J � � <br /> [�PLUMBING �'-r-�. � <br /> �� <br /> {�MECHANtCAR $ VALUATiOA!OF MECHANICAI.INSTACLATION �,'�c�� <br /> �]GAS [� ROOFiNG Q SPECtA1.Tl � t3THER <br /> =1NtSHED FLOOR ELEVA"f10PtS FLOOD ZQM1IE AREA QYES NO <br /> 3Ut1.DER �� COMPANY <br /> 3tGNA1'!!RE REGISTEREO Y/ N h'Ee CuRixEn Y/N <br /> Address Ucense# � � <br /> cLECTRICIAN � ( � f COMPANY /�.. 1%"'��~ '� <br /> �[GNATURE r�"'�- � t�'�'P � � REGIStERED Y I R1 FEE CURREh Y I N <br /> Address License# � � <br /> �LUMBER � CQMPANY <br /> 41GNATUR� RBGISTEREO Y i N FEE Ct1RRER Y/N <br /> Address License# � � <br /> AEGHAfi�2tGAl COMPAMf <br /> i1GNA1URE REGlSTEREO Y t N �E�CUrtREt� Y t N <br /> Address License# � �� <br /> )THER COMPARtY <br /> RIGNATURE REGISTERED Y/ N �Ef�uattEt� Y t N <br /> Address l.tcense# � � <br /> tESlDENTIAL Attach{2).Plot Plans;(2)ssts o€Buflding.Plans;{1)set of�nergy-Forms;R-4-W Permit for new construcfion, <br /> Minimum ten(10).working days aRer submittal.date. Requlred onslte,.ConstrucUon Plans,Stormwater Pians w/Silt Fence installed, <br /> Sanitary Factlities&1 dumpster,Si#e VHortt Permtt for subdlvlstonsAarge projects <br /> :OMMERCIAI Attach{3)camplete sets'of 8u!ldirtg Plans plus a Life 9a€ety Page;(4}set of Energy Forms.R-O•W Permit for new cvnstruction. <br /> Minimum ten(10)working days after submittal date. Requlred onstfe,ConstrucRian Plans,Stormwater Pians w!Stit Fence Instailed, <br /> Sanitary Facilities&1 dumpster.Slte Work Pertntt for all new proJects.All commercial requirements must meet compliance <br /> HGN PERMIT Attach{2}sets nt Engitteered Ptans. ' �-- � ------ <br /> '"'•PROPERTY SURVE'Y required tor all NEW constsuctlon. �`�� <br /> 1If@GL�OStB: <br /> Fill out applicaQon completely. <br /> Owner 8 Contractor sign back of applicatlon,notarized <br /> If aver a2S00,a Hotice ot Gammencement Is reqylred.. {AJG upgrades over�7500} -, _ -_ , , �, , <br /> ' Agent(tor the contractot)or Power af Attamey(far:the awner)wauld�ti'�someone with notartzed tetter imm:pumer.authorizing same -�• "" , Y? <br /> tYER THE COtINTER PERMITT1Pt6 , (Froni of Apptica8on On(y}, .� : ` , � � � , , <br /> ;eraois tt shfngles Sewers Servlce.Upgrades A/C-' _ Fences,{PIbUSurvey/Footage} ; <br /> Drlveways-Not aver Counter tf an pubilc roadways..nesds ROW <br />