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813-780-0020 (�.IQ�/Oi L�t,,��'....,.,. . ..�����.nN�ilCc'a$10�1 Fax 813-780-0021 <br /> 4' Building Department <br /> Date Receiv�d '� � Phone Contact for Permittin - � b I <br /> Owner's P�ame � � OwrneP Phone Nuesnber <br /> Owner'�Address ��d4 (,l� C �(e� • Owrner Phon�Numb�r <br /> Fee Simpi�TIFl�holder Plame Owner Phone Wum6er <br /> Fee Simple Titleholder Address <br /> `^ � °-�. <br /> JOB ADDRESS � �,�.J � W I � ���• L07# <br /> SUBDI!lISIOf� ' '� � v PARCEL ID� �l.i"� � l4�' ���1� '�Q(�lA� `���N <br /> (OBYAIPIED FROM.PROAERTYTNt NOTICE� <br /> IAfORI(PROPOSED NEVv CONSTR ADD/ALT Q SIGN� Q Q DEMOLISH <br /> IMSTALL e REPP�IR <br /> PROPOSED:USE Q SFR Q COMM Q OTHER <br /> T1fPE OF COldSTRUCTiOR9 Q BLOCK " Q FI2AME [� STEEL Q <br /> DESCRIPYIOPI OF W012K �� .(�, <br /> � <br /> BUILDING SIZE SQ FOOYAGE� HEIGHT - <br /> QBUILDING S VALUATIOfV OF TOT,4L CONSTRl1CTION <br /> QELECTRICAL $ - - AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUNIBINC3 $ , � <br /> .Q�Y <br /> OMECHANICAL $ V.aLUAT[OY QF C�CHANICAL INSTALLATIOIV '1 � (�(/2� <br /> �V <br /> C��S Q ROOFING [� SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> OUILDER COMPANY <br /> S16PlA91lRE REGISTERED Y/ N �cuwz� Y,r�; <br /> Address ���Q� <br /> fELECTttICIAP9 COAAPANY � <br /> S(GPIATURE � REGISTERED Y/ iV - �E CURREt� Y/N -. <br /> AddP�ss - . <br /> Lfcense# - <br /> _ , <br /> PLUM�EI3 COMPi�P1Y l. � ���(� . � - <br /> SIGNATIJRE REGISTERED Y./.N �ecuw�n Y <br /> Adidr�ss (� �, License# �l�cJ�' ��O��a � <br /> t�flECF1�IC�L COMPAPIY <br /> SICaWAYURE REGISTERED Y/ N FEE CURREP_ Y/N - <br /> Address - License# � <br /> OYFIER COMWI�RIY � , <br /> SIGRWTUFtE REGISTERED Y/ N . FEE CURRE� Y/N <br /> AdtJY03S LIC@�Se# � - <br /> RESlDERl77AL •Attach(2)Plof Rlans;.(2)sets of Building Plans;(1)set of Energy��oims;R=0-W Permit far.new construction, � - <br /> Minimum.ten.(10)working_days after;subrtilttal date.=Requlred ons(te,ConstrucHon Plans;Stormwater Plans w/Siit"Fenca�s.,�.1�, <br /> �s <br /> Sanitary FaciltBes&1.dumpster.Slte Wor1c Perrnit for subdivisionsBarge projects � <br /> COf�ii�J��Ci� Attach(3)complete seCs of Buildirig"Plans plus a Life Safety Page;(1)set of Energy Forms.R-0.W Permif for new con,sh-,�� <br /> I Minimum ten(10)working days after submfttal date. Required onsite,Constructlon Plans,Stortnwater Plans w/Sitt Fence��a3, - <br /> Sanitary Facllities 81 dumpster.Site Work Permit for all new projects.A!I commercial requfrements must meet compliarrce <br /> SiGPD PERRfi1T AttacFi"(2)sets of Engineered Plans. _ <br /> "'•'PROPERTY SURVEY required for all NEW construction. <br /> D[P�ctlons: - <br /> FIII out appltcaUon completely. _ _ <br /> Ouvner 8 Contractor sign back of applicatlon,notarized '• _ <br /> If oveP$2500,�Plo4tc�of Cornmancement is required. (A!C upgrade�over$T500) , <br /> ; " �,��t(€or the contractar)or Powar of Attomey(for ttie owner)would be someone with notarized letter from owner authorizing same <br /> `�"'�"-��.-"�=;k ►-F"ER��lA IT"f9NG (Front of Appllcation Only) <br /> "-"�"'�'�� ��� Serv�ce Upgrades A/C Fences(PIoUSurvey/Faotage) <br /> '��?li�r�+n!ys-r�:::���;•x��..�'��fs..needs ROW -- , ' <br /> Y. � .. . . <br /> '��� ' .�. ' � . � _ ._,_ <br /> ��._ � � - _h?4>.".'�•:?,�'�"�.__...�.r��.__ _ _'_ Y "'_'�__�...,�.�__ '"' "' "' <br />