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, ' Z_ ��;i1S gullding Department <br /> H <br /> Date Recelved g'�3 <br /> Pho e.�ontact fo�Permlttln 2 � -- ��1'6S <br /> Owne�'s Name �+►u i.D` Pel ke Owner Phone Numb r Z-�R "3�'��336 <br /> owner's Address 7 33� F-�z9�fA�d �a�p Owner Phone Numb r � <br /> Fee Simple Titleholder Name C Owner Phone Numb r <br /> Fee Simple Titleholder Addreaa <br /> JOBADDRE33 133� Ni��► NC� �ooP 2ep�R.Y�+�,IS t-=L 33S"Y/ LOT# �JD <br /> susnivisioN �A�C- ���1 PARCEL ID# 3`i -2 S-2t- O I op - 000d0 - �30� <br /> (ONTAINED FROM P OPI°_RTY T'AX NOTIGE) <br /> WoRK PROPOSED e nie coNSrR 8 ADD/ALT [�� SIGN [� �C] DEMOUSH <br /> IIVS ALL REPAIR <br /> PROPOSED USE Q 5FR Q COMM ��� OTHER <br /> TYPE OF CON3TRUCTION Q EtLO K Q FRAME C] STEEL Q ' ' <br /> DESCRIPTIONOFWORK ��{{�`�L �A^�9e-pkTc�' AIc �.�STa,� �ySeere FI�/�„� ,��qL N�7JPNr,nP, <br /> BUILDIN(i SIZE SQ FOOTA(3EC� HEIOHT <br /> ; <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION � <br /> DELECTRICAL $ AMP SERVICE Q PROO ESS EN6RGY Q W.R.E.C. - <br /> QPLUMBINO � . <br /> ECHANICAL $ c�9 0 0. p VALUATION OF MECHANICAL INSTALLATION <br /> [�GAS [� R�JO ING � SPECIALTY �,� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY ' <br /> 51GNATURE REGISTERED Y/ N FE CURRE� Y/N <br /> Address Llcens # <br /> ?LECTRICIAN COMPANY <br /> 31GNATURE REGISTERED Y/ N � FE CURRE� � Y/N <br /> Address Licens # <br /> 'LUMBER COMPANY <br /> �IGNATURE ' ' REO�s7EReo , Y/ N FE CURRE� Y/N <br /> Address � Llcens # <br /> � <br /> 1ECHANICAL MPANY I� ��S�t,�a 5� � (,,.J I, S c� <br /> IGNATURE • REOISTERED � Y/ N FE CURRE� � Y/N <br /> Addresa � Z l�.�S(�I� /31u�T',�A. FL "33�-��� Ucens # f C.�� � g��3��� <br /> �THER COMPANY <br /> IGNATURE REOISTERED � Y/ N FE CURRE� Y/N <br /> Address � License# <br /> ESIDENTIAL Attach(2)Plot Plans;,(2)sets o Building Pians;(1)set of Energy Forms;R-O-W Permit for ew construction, <br /> Minimum ten(10)working days fter submlttal date. Required onsite,;ConstrucUon Plans,S ormwater Plans w/Sflt Fence Instailed, <br /> - �-----8anit�-ry.F-a^�!ltls�R=!=c?u��pster-Slie-W�rk.Permit-fo�subdivislons/large,projects-: - - - - -- — ._ _� __._ -_.-- . —�-�___- -_ <br /> OMMERCIAL Attach(3)complete sets of Eiull ing Plans plus a LiFe Safety Page;(1)set of Energy Forms. R-O-W Permit for new constructlon. <br /> Minimum ten(10)worliing d�ys fter submlttal date. Requlred onslte,.Construction Plans,S ormwater Plans w/Slit Fence installed, <br /> Sanitary Facilities&1 dumpster Site Work Permit for ail new pro)ects.All commerclal requi m�nts must meeC compllance <br /> 'GN PERMIT Attach(2)sets of Engineereci PI ns. <br /> ""'PROPERTY SURVEY requl d for all NEW constructlon. <br /> rectlons: <br /> FIII out application completely. <br /> Ovmer&Contrector sign back oi application,n tarized <br /> If over 52500,a Notice of Commencemerit i required. (A/C upgrades over 37500) <br /> Agent(for the contractor)or Power o;f Attorriey for the owner)would be someone with�otarized letter from ovtimer authorizing same <br /> IER THE COUNTER PERMITTING (Froiit o Application Only) <br /> sroofs If shingles Sewers Service Upgr des A/C Fences(Plot/SurveylFootage) <br /> Driveways-Not over Counter if on public roE�d ys..needs RO.W <br />