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<br /> 813-�80-0020 T CI af Ze h rhills Permit A �IC�t1011 Fax 813-780-Oq21
<br /> , tY P Y pP
<br /> 8uiiding Qepartment
<br /> Dats Recelved i �Phane,Contact for.Perniittio � -
<br /> Oxrner's Naml �OGv�� Ownar Phone Number � u�� '�'��
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<br /> Owner's Address �a �I�n J`�'" , •Owner Phone Number
<br /> Fee Slmple Tltleholder Name � � Owner Phone Number �— �
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<br /> Fee Simple Tt�leholder Addre�s '
<br /> I ��J08 ADDRESS �J ! ��"� �f LOT#
<br /> SUBDIViSlO I �� � PARCEL ID#
<br /> I � (OBTAINED FROM PROPBRTY TAX N0710E)
<br /> WORlC PRQP�QSED - -.NEW C4N5TR . ADQ/A�.T �] SIGN� Q Q DEMOI.ISH
<br /> II ' e, INSTALL 8� -.� REPAIR �
<br /> FRQF05ED=�SE Q SFR � �CQMM � OTF{ER '
<br /> TYPE OF CONSTRUCTION Q� � BI.00K " `Q FRAME � .STEEG Q _
<br /> DESCRIPTIO OF WORK L�' � ��'� ''rr�G" L'n i �.-'`
<br /> BUFt,DlNG'S!il - � SQ FOOTAGE�� .HEIGHT����
<br /> �8�������'' � " . VAIUATiON�t}F�TO'fAL CONS'fRUCTIOiV' '
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<br />', QE� CTR1CAl $ ' AMP SERVICE. Q PROGF2ESS ENERGY Q W.F2.E.C.
<br />' . QPL MBING ,f �� ^ � �8t�V
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<br /> �ME HANtCAL $ VALUATION OF'MECHANICAL INSTALLATIt3N '
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<br /> QGA Q ROOFING Q SPECtAL.TY L,� OTHER �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> i BUIF.DER GOMFi4�lY�
<br /> ' 31GNATURE REGISTERED Y/ N . FEE CURRE� ` Y/N�
<br /> Address � - Ltcanse# { �
<br /> EIECTRtC _ : CdMPIWY = , -
<br /> SIGNATURE � REGISTERED Y/ N FEE'CURRE�" �Y/N
<br /> IAddress � � , . License.# �� 9 i
<br /> PIUMBER '_ , CO�IPANY ; � , ° . .
<br /> SIGNA7URE' , REGIBTERED. Y./ N. FEE CURRED ' Y./N. °�
<br /> Addres$ . ., ' L�cense.# � ��•: 1
<br /> _ � "l��'lvfr ,�('
<br /> MECHANICAf.' ,�� ��,� COMPAFlY �... /t 1 � � ���"'"z i�t��-_
<br /> 3iGNATURE• - - • ��� REGISTERED , N . FEE CU �/rN .
<br /> Address��' :.- ',������'�, ji o,$ ;.� � � , • license# � � f� :7
<br /> i OTNElt ' _ ` ` ` ' ':COMPI4NY .� . _ .
<br /> SIGNATURE =- ~ '�' • 9 � ` � ' REGISTERE�' ' Y/ N_._ Fee CURRen• Y/N
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<br /> Addr68� "' � ' s ` ` = lice`ltSB#
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<br /> RESlDENTIA4:_.: �:A#ta'cti;(2}wR1ot�P,lans,:.(2}seis:of�Buliiling'Riens,'(1}'sef of�Energy�Foims;R-O�-iN'Peririlt fiar new�nstructian, �:, ,
<br /> � � Minimum.ten�(�1,0):vy,ortiing,,days:after"subrinlfEa�'date:;ftequired onsite;.Ganstruction'Rl�ans;wStormwate�'Pians wi Siit Fencerinstalled,
<br /> ���'����Sanita��Facillties;i�e1=;dumpster:Site�,Work.,P.,ermit for subdivlsions/Iarge,proJecfs;._ - ;,�, t� � '��
<br /> COMMERCFAL Attach 3}�coinplete sets`�of Buililing Plans plus a�Ltfe Saft�ty Page;{1}set of Energy Forms.R-Q W Penni##ar nev+i construction.�
<br /> Minimum ten(10)working days'after submlttal date. Required onsite,Construckian Plans,Storn�water Plans w!Siit Fence instailed,
<br /> Sanitary FaciliUes&1 dumpster.Site Work Permit for all neVu,�projects.`All commerGal requlrements.must meet compllance� ' �
<br /> SIGN.PERMI li Attac:ii(2�se#s of'�nglneered:.Ptans;, r �_:��- �_��;._ , - , '
<br /> ""PROPERTY SURVEY,reyufred for all NE_W.construction.
<br /> Qi�ct�ans• .,.;._,,:_ ... , ,
<br /> FIII out applicatlon completely.
<br /> Qwner&�Contractor stgn back of applicatlon,natadzed
<br /> If over�2500,a Notice of Commencement ts requlred. {AtC upgrades over�7500j ;
<br /> �� II '." k•=:ir�,`.'..; .
<br /> Agent(fc}r the contractor.)�or Powe�df Attbmey(fur tFie owner)would be&omeone withYnotarized letter from owner authorizing same
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<br /> DVER THE C�}�UN'iERfPERM17TING..., __{Front af APAlication t}n1y}_. .
<br /> Reroohs if shirigles Sewers Service Upgrades A/C Fences(F'lot/Survey/Foot�ge)
<br /> s.,
<br /> Drivew� Not over Counter tf an publia roaduvays..iieeds ROW
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