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813-780-0020 Lity ot[ phyrni��s rermit App�ication rax-��s-iau-uuz�
<br /> Building DepartmenE
<br /> Date Received phone ontact for Permitting � — 6 3D v
<br /> Owner's Name .�5�i 1 1�°� S �� OwnerPhone Number ��� �� 4 �
<br /> Owner's Address �� � Owner Phone Number �
<br /> Fee Simple Titleholder Name Owner Phone Number '
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ��\n~� LOT# ��
<br /> SUBDIVISION . PARCEL ID#
<br /> _ _ _ __ ._ __ _ _ _ (OBTAINED FROM PROPERTY TAX NOTICE) __ _
<br /> WORK PROPOSED B WS7'ALLSTR� REP ART �J SIGN Q Q DEMOLISH
<br /> PROPOSED USE Q SFR Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
<br /> � 11 � 11 ,+�lC— Qs��,w1 � _�
<br /> DESCRIPTION OF WORK l��
<br /> BUILDING SIZE SQ FOOTAG � HEIGHT
<br /> [�]BUILDING $���� � VA UATION OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ ��� ,.� AM SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> QMECHANICAL $ VA UATION OF MECHANICAL INSTALLATION � ��
<br /> ,��`�
<br />� QGAS Q ROOFING Q SPECIALTY Q OTHER � ��
<br />,I
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER - �`' - _ ��a�ANY ��`'� ��—�
<br /> SIGNATUR REGISTERED Y/ N . FEE CURRE� Y/N
<br /> Address S '� �� � License#
<br /> �a.o �
<br /> I ELECTRICIAN c� i(}� � � COMPANY (n�
<br /> SIGNATURE �� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address • License# �
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N ' �
<br /> Address License#
<br /> MECHANICAL `COM ANY C���GY \
<br /> SIGNATURE �� �� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plan ;(1)set of E�ergy Forms;R-O-W Permit for new construction,. �
<br /> Minimum ten(10)working days after submitta date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities 8 1 dumpster,Site Work P rmit for subdivisionsAarge projects
<br /> COMMERCIAL Attach(3)complete sets of Building Plans plu a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcdon.
<br />� Minimum ten(10)working days after submitta date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities 8 1 dumpster.Site Work P rmit for all new projects.All commercial requirements must meet compliance •
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans.
<br /> "'"PROPERTIf SURVEY requlred fo�all NE construcllon.
<br /> Directions:
<br /> Fill out application completely. �
<br /> Owner 8 Confractor sign back of application,notarized '
<br /> If over$2500,a Notice of Commencement is required. ( C upgrades over$7500) ,_ • , �
<br /> *' Agent(for the contractor)or Power of Attomey(for the owne)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITTING (Front of Application nly)
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
<br /> .,� .••.a r�h�aNn+o.. z 9a*.Tse�ost_�...,!�in.,x...,�.n..w.,.-v..x.r_..., a ry 1
<br /> Driveways-Not over Cof�nter"�f�it��u�lic roaci�ways:.needs:, .1N,. ;'"`" t � ,�-, '�' ;,. '-
<br /> �;i O',��:�: ''.:.Kt�:t:�.�. ;c�. 4� ,� ;Tii'. l..it: .�u'�i., .. .. .
<br /> �4 ?:;,.,4•,5, :�,,,;� ,. :mi ;.r;: 'f�• g ,... ,�3:v�C(?:.:S' ., , .
<br /> i . ,���,.,��,�..�.. _,-,�. , .,. .. ��,i, 1'� �`` . ....... .. . . ...'is;_ -- ." :
<br /> I :' :rtl" 1� 'Y! '�
<br /> �:I�ifeN�+V�-Ai�C�AI+�-b.a.vla.�,c..��t�-.v-fnr�li�yw+1 Yv� cW�•• 'i:��..r+n. .��... err4�.-•.+. ..y . .r-.�,_=a.
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