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- � � <br /> � a��-�ao-oozo City of� phyrhiils Permi#Application �ax-813-78d-0021 <br /> y , euilding Department � <br /> �+� - <br /> � � <br /> �ate�eceived phone ontact f r Permittin ��3 7�� -- ���� <br /> Ov+tner•s Idame Cm°"'/ ���� L�-�. ' Cbwner 9'hone f�umber �� "LQ7'�'�'�� <br /> �vvuner's Address �! � ���� � ��G3 Owner Phone Idumber ��; <br /> Fee 5ir�ple Titleholder ldame C i � Cf�vner Phone Idumber � � <br /> i � <br /> i <br /> Fee Simple Titiehalder Address � <br /> � <br /> ,eo��►D�R��s �$�� l� �le- �v' . �'c� �7 �tt�s ��3v� �o�# �..�' <br /> sca�t�c�sim� !?�1,�t-�t�� ���� P�►ricg�.sa# �� o�� �l �� d��.t3t� Q4�1.� <br /> � (OBTAINED FROM PROPERTY TAX NOTICE) <br /> MlO�t4t PROPQSED � NEW G{}NS7R ADDIAL � SSGN Q Q DEMt)�.tSN <br /> INSTALL REFAIR <br /> �9tOP03��CO�E SFR Q COMM C� OTHER <br /> TYP�OE GOtdSTRUCTIOId Q BLOCK Q FRAME 0 STEEL Q <br /> D�SCRIPTIOM OF H!►ORK �/�" ������� ��""� L ` � <br /> ��lt�.blRtG�iZE � � SQ FOOTAG �_`_�� IiE1G}9T �-_�� <br /> QSUtLDING $ � �/ ��A'TION OF TOTAL CONSTRUCT{t3iV <br /> I <br /> QELECTRICAL {$6 �---`� A P SERVIGE Q PROGRESS ENERGY Q W.R.E.C. <br /> L ' <br /> QPLUMSING � �y y� i � <br /> � / �� � <br /> �MECHANIGAL $ � ��r"' �� V I.UATION'OF MECHANIGAL tNSTALtATlQ�I <br /> � I � <br /> ��AS [� ROOFlNG Q SPECIALTY � a���� � <br /> F�IVISHED FLOOR ELEVATIONS L� � FLOODIZONE AREA QYES NO <br /> i <br /> � <br /> I � <br /> 0tD{�DER i COMPdlNY <br /> SIGId�►TUR� � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � I License# <br /> i i <br /> �L�c���c�a� ' COi�IPAtdY <br /> SIGiVNATUEZE � REGISTERED Y/ M FEE CURRE� Y/N <br /> �ddress � I l.icense# � <br /> i I <br /> PL�tflflBER � G014lIPAh1Y <br /> 51G�NATURE � RE�ISTEF2ED Y/ N F6E CURRE� Y/N <br /> �ddress i ( License# �- <br /> I <br /> ��CHAINICAL f��` � � Cf}4�PAIdY /�/�}` �P !" ��'-��o� - f <br /> SIGRIATURE '""� i RE�GISTERED Y/ N FEE CURRE� Y/N <br /> Address i � License# �,�,,,'�J�`I� °D <br /> � <br /> O'�`H1�Q� I ���a1tNl�dlt�Y <br /> SIGWa4TURE � REGISTERED Y/ I�I FEE CURRE� Y I N <br /> i <br /> Address � license# � <br /> � <br /> 42E31��iNT9AL Attach{2).Ptot Plans;{2)sets of Building Pi ns;(1}se�of Energy Farms;Ft-O-W Permit for new construction, <br /> Minimum ten(10)working days after submi tal date. Required onsite,Construction Pians,StormwaterPians wI Silt Fence instailed, <br /> Sanitary FacUities&1 dumpster;Site Work ermit for subdivisionsllarge projects <br /> CCii}fltUiE6tC1A� Attach{3}complete sets of Building Plans tus a�ife Safety Page;(1}set of Energy Forms.R-fl-W Fermit for new consUuc#ion. <br /> Minimum ten(10)working days after submi kal date. Required onsike,Construction Plans,Stormwater Plans w/Siit Fence instalied,- - - - <br /> Sanitary Facilities 8 1'dumpster.Site Work Parmit fariall new projects.All cammercial requirements must meet campliance <br /> Slt'xM FERiNitT Atfach(2}sets of Engtneered Plans. ' i <br /> """'PROPERTY SURVEY required for all N W cons#rUction. <br /> Directians: ; <br /> Fill out application campletely. j <br /> Owner&Canttactor sign back of appiicatton,notarized � � <br /> lf over 52500,a Tdotice of Commencement ts required. (A/C upgrades oeer$7500} <br /> '" Agent{for the contractor)or Power qf Attomey(for the o er)would be someone with notarized letter from owner authorizing same <br /> O!!�R THE COURITER PERMITTIMG (Frant of Appticati n{?nty} <br /> Reraofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) • <br /> Drivev�rays-Not over Counter if on public roadways..need i20W <br /> � <br /> � <br /> i <br />