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813aao-oo2o Ci of Ze h rliills Permit A lication Pax 813-780-Op21 <br /> tY P Y PP <br /> Build ng Qepartment <br /> Rate Recetved '7 �y „�pt�~ � Phone Contact or PertnitEln �} J� ,5� 3 _ ta� 2 � <br /> Owner's Name 0/Z,2D� S'Tk�L Owner Phone Nnmber g��`�����'y�� <br /> Owner's Address .,)� � � C�U �L q r�b Drz�v� Owner Phone Number � � <br /> Fee Simple Tltleholder Name �� � Owner Phone Number � <br /> ! <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3� � � � �z q a �� 1��z��n-. LOT# �„�,� <br /> Si3BDIVtS10N �� �� PARC�L 1D# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPQSEQ N�trv CONSTR ADDIA T � SIGN Q [� DEMQl.ISH <br /> e INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMNI �� C}THEF2 <br /> TYPE OF CONSTRUCTION Q BLOCK [� FRAM C] STEEL Q <br /> _ . <br /> I DESCRIPT�ON OF WORK Fc i'�''DU� �NTieZ Ft �,c,S���✓� f�v,c a��✓C._. �, G d u s//=. <br /> i � <br />, 8UlLDlAIG S1ZE � � SQ FOOTAGE J���a s �". HEIGHT I� F' ' � <br /> i <br /> �BU«����' � ��o o L7 VALUATIO�QF TOTAt�CONSTRUCTION <br />� [�E�ECTRiCA[. � � AMP SERttE E Q PROGRESS EElERGY C] W.R.E.C. <br /> I <br />� <br /> QPl.UMBINC.�, � � <br /> QMECHANtGAI $ VALUA'Ct0 OF MECHANICAI.#4�lSTALLATION <br /> QGAS Q RQQFING [� SPECt' 'fY � 07'HER <br /> �i FINISH�D FLOOR ELEVATIONS FLOOL�ZONE AREA QYES NO ' <br /> � <br /> ' BUI�DER �, .,t'rl�,`G. %�' C MPANY �7l dl� �n13�t¢�c:,��.. �`,,,�� <br /> i SIGNATURE RE�I5TERED Y/ N FEE CURRE� Y/N <br /> i Address a Sa�j '�vLkrs y (�',��z,C. i2�a� j?t/tni�Ci r"� . �35G G License# �������/�/ � <br /> EI.EC7RICIAN COMPANY <br /> ' SIGNA7URE REGI$TERED Y/ N FEE CURRE� Y/N <br /> Addre�a I Ucense# � � <br /> P�UNIBER COMPANY ' <br /> �, SIGNATURE � REGI5TERED Y/ N FEE CURRE� Y/N <br /> I <br /> Address I License# � � <br /> ', MECHAPlICAl, C4MP�tMY <br /> ' SIGNATURE RE�ISTERED Y/ N FEE CURRE� Y/N <br /> � � <br /> Address � license# � � <br /> � <br /> OTHER CQ(Ii1PANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N. �'' <br /> Address I Cicense# �— � <br /> RESIDEN'[!Ak Attach(2}Piot Plans;.{2}sets af Biifldfng'Plans,{1)se#�of Energy�Facros;R-0=W Permit for new construcUon, ' <br /> Minlmum:ten(-10)working days after.subm�tta{da#e. Requtred onsite,ConstrucUon Plans;Stonnwater Plans w/Silt Fence installed, <br /> Sanitary FaciliBes,&•1-.dumpster,Site Work Permit for �ubdivisionsAarge proJects <br /> C4MMERCIAi. Attach(3)complete sets�of Bulldlttg Plarts plus a I.ife�afe#y Page;{1}set af Energy Forms.R-Q•W Fermit for new c�nsfruction. <br /> Minimum ten(10)working days after submithai date. F�equfred onsite,Constructian Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facili8es&1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compllance <br /> SlGN PERMtT At#ach{2}sets af Eaglneered Plans. <br /> "`"PROPERTY SURVEY required for all NEW constnfcUon. <br /> Directlons: <br /> FIII out appUcatlon completely. <br /> Owner&Contractor sign back of applicatlan,notarized <br /> if over S25flQ,a Notice of Commencement Is required. (AtC upgrades aver�7s00) <br /> '" Agent(for the contractor)or Power of Attamey(for the ouimer)would be someone with notarized letter from owner authorizing same <br /> DVER TliE Gt3UNTER PERMI'fTiNG {Front of Appfication On{y} <br /> Reroofs If shingles Sewers Service Upgrades A/C Fence (PIoUSurvey/Footage) <br /> Drlvewaya-Nat aver Caunter if on public roadways..neads f20W <br /> � <br />