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893-780-Q020 �i�y�f Z�phy�hills P�ermit Applica�ion Fax 813-780-0021 <br /> Building Departme»t <br /> . , - <br /> Date�t�celv�d ` Phoe�e Cont�cQ fmr Permiftin - � `�'��� — ���� <br /> O+uner's i�am� l.�C...' l � Owner Phane�lumis�r <br /> Ouvner's�ddress �� ,�` cJ 5 • f2uvner Phon�Ptuinber ,_ <br /> F�e S(m�aie Tl�l�haldee Name� �— � Owner Phane idumber <br /> F��S6rtnp1�41llehald�r Address <br /> aas�a����s '��' c�`�t.���.'. ��l �.�s�s �� <br /> su�o�visia� � ��.���v � �,aRc��.��# � � l�-� - C�l��Q `(J(�� �- ��� <br /> (08TdtNED FROi@!F�RQPERiY TAiC iVOTtGEj <br /> WOR�P'ROPIDS�i3 , e NEW COtVSTR� ADD/ALT �] SIGN� Q Q �EMOLISH <br /> INSTi4LL REPi�1R <br /> PRQPO��C?.USE Q SFR Q COMM � OTHER <br /> TYPE mF G�tdSTRUC'PtORi [� BLOCK ' Q FRAME �� S7EEL Q <br /> .: Y 1 . <br /> n�sc����o�o�wo�a Y 1�� �� <br /> BUILDItdG St�E SQ FOOTA�aE�� HEIGHT ��� <br /> OBUlLDl�tG �r� VAI.UATiOiV QF TOTAL COAJSTRtJCT10N <br /> DELECTRtGAL ($ � . � AMP SERViCE Q PRQGRESS ENERGY � W.Fi.E.C. <br /> E <br /> OPLUMBING �' ��,�a_^���� ' <br /> �MECHANIGAL $ � VALU�'.i104 C3�=r,4�G�hlCAi{t+1STALLATlQN <br /> Cjc�s Q ROOFING � s�ec�,.rr � o�E� <br /> FlNfSHED FLQOFt Et.EVAI'iC1NS FLOOD ZONE ARFJ�I QYES. NO <br /> �_.� - <br /> 0UlLC►�i� �O�PAAiY <br /> SI�SAfATURE REGtStERED Y/ N FEE CURREA Y!N ` - <br /> Addrsss Llcetise# �� � <br /> E��CT�IGIAld COWiFANY _ <br /> SlGNA�UR� � REG�STBRED Y/ h1 FF�CURFtE� 1(1 N <br /> ,��dr�s� � � Llcanse# �! ____ �� <br /> ��.un���� �� co�w��r � - �� irl Yr f -}"I t� <br /> SlGiUATUR� REGIS7ERED Y J.R1 FEE CURREM1 /i11. <br /> Address �,1 License# L ,,' �"l��� <br /> Ntf�CtlI�AIlC�l: � GOW9E�APtIf <br /> �!!iAl�,'P!J!@E t�Gts�t�o Y.i tV �E Cu�n Y/N <br /> Addr��s - License# � � <br /> O'YB�I�t� GUA�Pf�1AlY' . <br /> SlGRlAYU�E RE�ISzeaEQ Y I iV . ��cU�A Y i N _ <br /> �d�ee� . - Lidense# ( � <br /> 3tESiDEP!'TI�OL Attach(2j Ptof.Plans;(2)`sets of Building Plans;(1)set af Energy�Forms;R Q=W Peris�it t�ar new construc6on.. ' <br /> Minimum_ten(107 working`days after..suhriitttal date. Requlced onsite,ConstrucHors-Plans;Siormwater Plans w!8iit Fercce instailed, <br /> ' Sanifary FaclllBes&;9..dumpstet;�Slte Wark Permitfar subdivisi.on"s/large proJects,; _ � - <br /> COPflt���C1�l. fltkach(3}comjslete sets of Building Plans plus a�ife Safety Page;(1}set a#Energy Forms.R-O W Permit far new canstruction. <br /> M(nlmum ten(70}working days af#er submlttaf date. Required o�site,Construotian Pians,Stormwafer Pians w!Silt Fenrs installed, <br /> Sanitary FactNUss&!dumpster.Siter Work Permit far att new praJec#s.Ati commerciat requirements rriust meet comptiance <br /> SlGN PEF�MlT AttacFi(2)sets o€Engln�ered•Plans. . <br /> "••«PROPERTY SURVEY requirad far a!i NEW canstnst�t'son. .. <br /> C3lrac4tons: <br /> Fi!!out 2ppltcaUon c.crtrtptetely. <br /> � CA��ter�Cantractar sign back af apptEcatlan,natarized � <br /> �i cw-�SZ500,a Rlottc�af�amm�nc�menf ia raqoired. (d�►C up�rad��aver$7500j <br /> �` w�.�,,�^„,c�s,Z�-actor�or Power of Attomey(for the owner)vuould be someone with notarized Istter from owner sutharizing same <br /> �,"�Ic�,'.�'�r.'�Pr..�iT!'tNG {FrontofApplic�tion i�niy) <br /> � �� Service Upgrades A/C Fences(PIotJSurveyJFaotage} <br /> �a�.`;. , <br /> ::�«as�s;�;�:�~�,:.:��uays..needs ROW <br /> �:��._ � � - <br /> 9��: , , f .. J <br /> �.�':. � <br /> .. ... s�3y. . • <br />