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q�,rro�-v��cv city ot�epnyrhiiis Permit Application Fax-813-780-Od21
<br /> Suilding Depactmen i
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<br /> I te Receivs� Phone Contact for Permittin � C7 i 2�� - �d � �
<br /> rner`s Name � � L,+�l��s t l�lV �h'�i{.1��+ t?wner Phone Numbes ���"' � �- �� ,
<br /> rner's Address e1 ` �� �� ��l� �� Owner Phone Number � �
<br /> Owner Phone Number � 1
<br /> �Stmple 7ttlaholder Name (
<br /> e Simple Titleholder Address
<br /> B ADDRESS � t� t,e?�C3 '� � '�t�� oV�� LOT# �`�
<br /> �
<br /> aQms�oN �� PARCEL fD# ��i ��T �1' bZ� 0�' D!c�'Z?�-1�9�
<br /> (OBTAINED FROM PROPERTY TAX N0710E)
<br /> )RK PROpOSED e NEW CONSTR(a!;J ADD/ALT � SIGN Q [� DEMOLISH
<br /> INS7ALL U REPAIR
<br /> .OPOSED USE Q SFR [� COMM � OTHER
<br /> PE OF CONS7Rt1CTidN Q BLOCK [� FRAME � STEEI. Q
<br /> SCRIPTION OF WQRK � `�` 1 .� �7'a n.� c �G�I rf �` � �rl.�Y1� ' �1L.?�c�
<br /> 91.QIMG S1ZE �y� SQ FOOTAGE I HEIGHT �`
<br /> OBUILDING �� YALUATlON OF TOTA�COf�STRUCTiON
<br /> QELEC7RICAL $ AMP SERVICE � Q PROCyRESS ENERGY C] W.R.E.C.
<br /> QPLUMBING ($ ��
<br /> ��_
<br /> QMECNANICAi. $ j��� VALUATION OF MECHANIICAL INS7ALLATION
<br /> G
<br /> QGAS Q ROOFtNG C] SFEGIAITY � 07NER
<br /> ItSHED FLOOR ELEVATIONS C�---� FLOOD ZONE AREA QYES NO
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<br /> ILDER COMPANY �
<br /> ;NATURE REGISTERED Y/ N FEE CURR6� Y/N
<br /> Address � Lfcense# r� i �
<br /> °_CTRICIAN COMPANY �
<br /> �NATURE REGISTERED � Y! N FEE CURRE� Y/N
<br /> Address i Ltcense# �— �
<br /> JMBER COM PANY
<br /> �NATURE REGlSTERED Y! N FEE CURRE� Y J N
<br /> Address License# �— ��
<br /> CHANICAL - � � COMPANY �N-1�4S /'ti A-�� f�y�-S �`"/C w.-T
<br /> NATURE �e-G�� l /Z.L�-�'-�tt.,P�-- REC.,iSTERED Y i N �� RREh Y!N
<br /> Address License# (...���-� �`���{'t'�� �
<br /> fER COMPANY
<br /> NATURE REGIST�RED ! Y/ N FEE GURRER Y l N
<br /> Address - � Ucense# �4 �
<br /> SIDENTlAL Attach{2)Plot Plans;(2}sets of Buffding Plans;{1}set a#Energy Fomis;i2-d-W Permlt for new consttuctlon,
<br /> Minimum ten(10)workfng days after suhmlital date. Requtred onsite,�Construction Plans,Stormwater Plans w/Sflt Fence lnstaiied,
<br /> Santtary FacltiUes&1 dumpster,Si#e Work Permft for subdivislons/large proJects
<br /> AMERCIAL Attach{3}camptete sets of Buftding Plans ptus a Life Safety Page;(1}Iset of Energy Farms.R-O-W Permit for new construction.
<br /> Minimum ten(14)working days after submi#kal date. Required onsite,IConstruct(on Plans,Starmwater Pfans wi SHt Fence tnstafied,
<br /> Sanitary Facitities&1 dumpster.Site Work Permit for all new projects�All commercial requirements must meet compliance
<br /> N PERMIT Attach(2)sets of Engineerad Ptans. �
<br /> ""PROPERTY SURVEY required for aq NEW constructlon.
<br /> ct�ons: � �
<br /> FIII out appllcatian completely. 1 �, �
<br /> Owner&Contractor sign back of appltcation,notarized, ���, ; y , � `�; ,
<br /> if over�250d,a Notfce af CammQncement is required. (A/C.upgrad@s over 57500) • • ; �!�y ',,
<br /> A ent for the c�ntractor or Power of Attarn ^ �
<br /> g { } sy{for the owner}'woutd be stimeane with notarized letter fram owner authorizing same �'
<br /> ER THE COlJN7ER PERMtTTiNG (Front of Aqpiication Oniy} � . _ _ �
<br /> �ofs If shtngles Sewers Servica Upgrades A(C Fences{PtoUSutveylFaotage} �" ` � � „ �
<br /> __ .,u . „ � , ., - J. 'I, ,
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<br /> Driv�ways-Not over Counter if an pvblic rciaifways..needs ROW "` � ,,; . ` ` , . ` �' .
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