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' p,,.,o�w„�� c;iry ot�epnyrniits Permit Application Fax-813-780-tid21 <br />� Sutiding Department <br /> Ee Received + � � �,Q � phono Contact for PermlttU ` �-��� ` �� <br /> -- �L ��3-- `l l -- �3 � <br /> mer's Name � -�t- tU c. Owner Phone Number <br /> j ' 33S`i('� Ownsr Phone Number SU✓11n.-�2_. <br /> rnor's Address �1 � E.f � y yi � <br /> s Slmple Titleholder Name �,1.� /��+��`Gw l.-GC q°J c�1� �w�er Phone Number S�Yt'�-2, � <br /> 1 <br /> e Simple Titleholder Address l�1`�7 Gl. �� 1�vtA �'E* G1 ��-S ' `�` � `S�-' <br /> Q ,��^ , /�'',,,�, ! <br /> B ADDRESS SV`� G�cl� ��b '�' u U'd' i � `OT# <br /> `BDIV1510N �� � PaRCE�.�o# 3-�2. -�S �-��1 (? -� n 33 c�--�o! �? <br /> (OBTAINED FROM PROP6RTY TAX NOTICE) <br /> )RK PRdP08ED � NEW CONSTR 8 ADDlAtT �[ SlGN Q Q DEM4LlSN <br /> INSTALL REPAIR <br /> .OPOSED USE Q SFR Q COMM [� 07HER <br /> PE OF CON37RUCTION C,] BLOCK [�J FRAME � STEEL Q <br /> 8CRIPTION OF WORK +, a�� '� � <br /> 9l,QlNG SIZE �n�X 3�0� sa�oos,a�e �1�3 H� HEIGHT `t s"Ttir'I`�-.S <br /> QBUILDING ��� VALUATION OF 70TAL CONSTRllCTIQN <br /> QELECTRICAI. � � AMP SERVICE Q PROGRESS ENEFtGY Q W.R.E.C. <br /> �LUMBiNG $ ��w�� <br /> [�MECWANICAL � � VALUATION OF MECHANICAL INS7AI.LATION <br /> �]GAS Q ROOFING [� SPECIAITY [� OTHER <br /> ISSHED FLOOR ELEVATIONS �� FIOOD ZONE AREA QYES NQ <br /> ILDER - COMPANY <br /> ➢NATilRE REGISTEREp Y/ N FEE CURRE� Y/N <br /> Address Lfcense# �—� � <br /> :CTRICIAN � COMPANY <br /> �NATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addrass Ucense# � ^� <br /> )MBER �" COMPANY �� �t1����`� ,SQn.tIG�',S .��, <br /> sNATURE REGtSTERED / N FEE CURRE� Y/N <br /> Address �cy"� VG� � J�y�r� �,U�,�r � $3S4� License# �� ��Z�y��}��� <br /> CHANICAE. CdMPANY <br /> NA7URE REfiaISTERED Y/ N FEE CURRER Y J N <br /> Address License# �— � <br /> {ER � C08APAidY <br /> NATURE REGIST�RED Y 1 N FEE GllRRE� Y/N <br /> Address License# � � <br /> tiQENT4AL Attach{2)Piot Plans;(2}sets of Building Plans;(1}set of Energy Farms;R-O-W Pertnit for new cansbvcUon, <br /> Minimum ten(10)worktng days after submittal date. Requtred onstte,Canstruetton Plans,Stormwater Rians w!Sflt Fe�ce 3nstalted, <br /> Sanitary Facilltles&1 dumpster,Site Work Permit for subdivislons/large projects <br /> AMERCIAI. Rt#ach{3}compiete sets of Bultding Plans plus a Life Safety Page;(1}set of Energy Forms,R-O-W PeRnit for new construc8on. <br /> Minimum ten{10)working days after submittal date. Rsqufred ons!#e,ConstrucUan Plans,Stormwater Plans w!Silt Fence Instalied, <br /> 8an(tary Faciiltiss&1 dumpster.Site Work Permlt for all new proJects.All commercial requlrements must meet compliance , _ <br /> N PERMlT Attach{2)sets of Engineered Pians. � � � <br /> ."""PROPERTY SURVHY required for aA NEW construoBon. <br /> ctlons; <br /> FAI aut appUcallon campletely. <br /> Owner&Contractor sign back of application,notarized <br /> tf aver�2500,a Notice af Commencemant is requirad. (A/C upgradas over$750Q) <br /> Agent(far khe contractor)or Pawer of Attamey(for the owner)woutd be someane with notarized tetter from owner authorizing same <br /> :R THE COUNT'ER PERMITitFtG (Front of Appliq8an Onty) <br /> iofs if sMngles Sewers Service tlpgrades A(G Fences(PiotlSurveylFootage} <br /> Driveways-Not over Caun#er if on public roadways..needs ROW <br />