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<br /> a'�� '813=zao=ooio`:...,:�,;-,::;' °..,- �,-� ,;�. s Cityof_��phyrhills'�Permit�Appl,i,catio'r1'. ����,,�.~-:.�'j, '-js Fax-813-7$4-0021
<br /> a .�'`.a f"i':;; , ,._ � „ , . .(:.s� � Buqd�ng Depaitment; � .,
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<br /> Date Received . -�t`r=2�:'._ . Phone Contaotfor Parmittie ���._c.1i°� �aZ��
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<br /> Ownar's Name � Clwner Phcae FZumber „�1�,�1
<br /> . Owner's Address ���J' c"� �/ Owner Phane Number � =� ��
<br /> Fee Simple Titleholder Name � � Owoer Phone Number �— �
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<br /> Fee Simple Tltlehalder Address
<br /> JOB ADDRESS �� � � LOT# C�
<br /> SUBDIVISION PARCEI.ID� 5 oc�"oC 1^ � /Q�^)0�3 C�O "000C'J
<br /> (OBTAINED FROM PROPERTY TAX'NOTICE)
<br /> W4RK PROPOSED NEVU CONSTR ADDJAI.T [�` SiGN [� 0 DEMOLISH
<br /> INSTAI.L REPAIR
<br /> PROPQSEi}USE Q SFR � CflMM C„� OTHER d�i � o
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME STEEL Q
<br /> DESCRIPTION OF WORK F"� �-- �� �- �` ( 3 � (� cS .
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<br /> BUII.DING SIZE SQ FOQTAGE J3V �� HEIGMT �
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<br /> ������i��`' �,,�`����° VAL.UATION OF TOTAL CQNSTRUCTION � ����
<br /> QE�ECTRlCA� ($ � AMP SERVICE � PROGRESS ENERGY Q tt�1.R.E.C.
<br /> �._.__
<br /> QP�UMBING ($ —� ������
<br /> ��— . IL�r�
<br /> OMECHANtCAI $ VAl.UATtQN OF tVEECHANICAI iNS7ALtAT101V � L���
<br /> QGAS [� RQOFING Q SPECIAl.TY � OTHER ��
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES ��� ;;�G;,��!C"�
<br /> � �.�C.t�� tf '�-(:.:t'Y
<br /> BUI�DEft j �' PAiNY '� C..a/�'A�r9 '
<br /> t�C.. ,
<br /> SIGNATURE REGISTEREQ N FEE CURREP Y/N
<br /> Address �� „ n � License# ��~1�J]y��� �
<br /> f l � t /`3`�� (lc-�L�' .
<br /> E�EC?RtC1AFt � � . ��COMP�
<br /> SIGNATURE � REC,ISTERED Y/ N FEE CURRE� Y/N
<br /> Address ��� (�� i� ���'. LL'b��U���.'- � License# �Q�ti-7 B�j �
<br /> PLUMBER �v ' OMP� CJ
<br /> � � �
<br /> SIGNATURE REGISTERED N FEE CURRE� Y/N
<br /> Address ,� � " , � ��}I License# G�. g
<br /> MECt#ANICAL Ct1MPANY '�g t'�1 G'�� � � "``
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address I Ucense# �--�'`'1"L--t L7��l���
<br /> OTNER `� �—��`"'�`� COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> AddresS � LicenSe# � �
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<br /> RESlDEN'FIAt. Attach{2)Plat Plans,{2}sets af.8uiiding'Plac�s;{1}set af Erietgy Fartns;R-O-W Pertnit far naw canstruoi�on,
<br /> Minimum ten(10)•working days aftersubmittal date. Requlred onsite,Construction Plans;Stormwater Plans w/Sllt Fence(nstalled,
<br /> SaNtary FaGllUes.&-.1.dumpster,,Site Work Permit for subdivlsio�sflarge proJects
<br /> GOMME4tG1AL At#ach(3}campiete sets of Buiitllrig Piaris plus a life Safety Page;{1}set of Ener�y Fqrms.R-Q W Permit for new canshvctian.
<br /> Minimum ten(10)working days'after submittal date. Required ansite,ConsUucdon Plans,Stormwater Plans w!Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permtt for ail nev�r proJecks.All commercial requlrements must meet compllance
<br /> Sl�N PERMIT Attacti{2)sets of Englneered�Plans. . �
<br /> ""PROPERTY SURVEY required for all NEW construction.� '
<br /> f Dira�tipns: '
<br /> ,' �fll out applicatlon completely. f
<br /> , �Owner&Contractor sign back of appUcatlon,notarized
<br /> �'tf aver�2500,a Ptatice af Commencemant is requtred. {AlC upgrades�aver;T540)
<br /> � J' Agent(for the contractor)or Power of Attomey(for the owner)would be so�eone with notarized letter from owner authorizing same
<br /> l`-�VER THE COUHi'ER PERMiT71NG {Front af Appllcation Only}
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Faotage)
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<br /> Driveways-Not over Caunter if on publlc roadways..needs ROW �
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