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�,�-,aw,,,,�� c;ity ot Gephyrhitis Permit Appiication Fax-813-780-Od21 <br /> ; Buflding Department <br /> ,te Reaelved Phone Contact for PermitNn — <br /> ``�" �� � Owner Phone Number <br /> vner's Name � — <br /> rner's Address Owner Phone Number <br /> e Slmpl�Tltloholder Name �— Owner Phona Number � <br /> e Simple Tltleholder Address <br /> �B ADdRESS � t'""i�`� o �t' �, LOT# � <br /> !BplVISION �_ �� PARGEL ID# <br /> (08TAINED FRdM PRdPERTY TAX NOTtGE} <br /> �RK PROPOSED e NEW CONSTR 8 ADD/ALT S1GN Q Q DEMOLISH <br /> iNSTAIL REPAIR <br /> :OPOSED USE Q SFR Q COMM C� OTHER <br /> PE OF CONSTRUCTION Q BIOCK [� FRAME � STEEL Q <br /> , :SGRIPI'1dN OF WORK '�w t D0 �. �J"' �� �u �c1�•. <br /> I�LDING SIZE ���� SQ FOOTAGE[,u„] HEIGHT ��� <br /> OBt11LOtNG �$ .� VALUATION OF TOTAI.COf+lSTRUCTIOIV <br /> � <br /> C]EIECTRiCAi. $ ���t J� AMR SEf2ViCE [� PROGRESS ENERGY [� W.R.E.C. <br /> OPLUMBfNCa �� <br /> QMECHAMCAL ($ � � VAI.UATIQN t�F MECHANlGA�INSTAt.lATION <br /> �_ <br /> QGAS Q ROOFING Q SPECIALTY � 4THER <br /> ttSHED FLOOR ELEVATIONS ��� FLOOD ZOME AREA QYES NO <br /> lLDER _`� CdMPANY <br /> iNATURE �� _,� REGISTERED Y J N FEE CURRE� Y/N <br /> Address I.(cense# � � <br /> �—�— <br /> :CTR1Gt/W����"�`����t� COMPANY `Pi� c N+•t. <br /> �NATURE ����� V �`�-�. REGISTERBD Y/ N FEE CURRE� Y/N <br /> Address � 'b �i- Llcense# �C y�D� �3��i ! <br /> JMSER � � COMPANY <br /> �NATURE R��ts��z�o Y! N FEE CURRE� Y/N <br /> Address I.icense# �— �� <br /> CHANICAL ' GOMPA�IY <br /> NATURE REGtSTERED Y I N FEE CURREM1 Y J N <br /> Address License# �—�_�� <br /> �ER � � COMPANY <br /> NATURE REGIST�RED Y! N FEE CURREh Y i N <br /> Address License# �i � <br /> ilDENTIAL Attach(2)Plot Ptans;(2)sets of Building Ptans;(i)set of Energy Forms;R-O-W Permit far new conshuction, <br /> Minimum ten(10j working days affer submittal date. FtequUed onsite,Constructlon Plans,Stormwater Plans w!311t Fence fnstalted, <br /> Sanitary Facilitles&1 dumpster;Site Work Permlt for subdivisionsAarge proJects <br /> AMERCtAL Attach(3)aamplete sets of Bulldtng Plans plus a Ufe Safety Page;(1)set of Energy Forms.R-4-W#'e�nft for new constn�ctlott. <br /> Minimum ten(10}working days aRer submittal date. Requlred onsite,Construction Plans,Starmwater Plans wli SAt Fence instafled, <br /> Santtary FacillNes&1 dumpster.Site Woilc Permit for a11 ,new proJeats.AI!commetclal requirements must�meet ccmpilanc�-' <br /> N PERMIT Attach(2)sets of Engineered plans. � ' � ' � - <br /> `�"'PROPERTY SURVEY required far all NEW constructlon. <br /> Ctio�S: <br /> Ft�l out app(Icadon completely. <br /> Owner&Contractor sign back of appllcatlon,notarized <br /> If over$2500,a Notlee of Commencement!s requlred. (AfC upgrades over�7540} <br /> Agent(for the cantractvr)or Power of Attomey(tar the awner}wouid be someone with notarized�etter from owner authorizing same <br /> :R THE COUNTER PERMITTING (Fronk of Applica8an Qnly) <br /> �afs if shingles Sewers Service Upgrades A/C Fences(Plot(SurveylPootage) <br /> Drlvaways-Not aver Counter ff on publlc roadways..needs ROW <br />