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' � s�a-7aaoozo Cifiy of��phyehiils P�rmit Applica�i�� Fax-813-T80-Q021 <br /> @uilding Department <br /> Date��ce�vmoi �hone�on4ac4 for�ernelY4in �4� ""t�� � 1 <br /> �wn�r's�larm� 1✓l,Y 1 � � �irnop�9��nee�uanb�e <br /> Owrner°s sAcYs�r�s� `�"1 tSP t�' W l. �e�J � � �nteagr��voe��6�eamber �— � <br /> F�e Simp��TIQO�hold�r R9�m� Oenm�r�hone P9�amb�r �— � <br /> Fe�S�lrerpi�TlBleholtler�¢9dress3 <br /> Jo��a����s �'JI�I C�U�GI�� IO�E� �Y • �o�� [� <br /> �v$�t�as��� �1 �,�1 �11 Vf,cr�( �����«� � <br /> {O$YAiNED FROA9 PFtOP�ttlY TA7C tddTtCEj <br /> 4tNOk'6L 4�IROP�OSE� , � �tEW toNStR 8 rqDt7tALT � SiGRI � Q DEMOL.iSH <br /> INSTALL. REPAIR <br /> P�OPOS�D:IUSE Q SFFt Q COMM C� OTHEF3 <br /> TYP�OF COR9S7�UCTII�R9 Q �LOCft " Q FRAME C� STEE� Q <br /> ��s����������o�� ��v� -� �n i c� � �.i I � <br /> �U1LDl�lG�1�E �Q FB301'���C� �I�ItvF4T ��,� <br /> Q BUILDIf�G �� VALUATtflYt!OF TOTAf.CONSTRC'tCTit�N <br /> QELECI"RICAL � � AMP SEFtVICE Q PROGftE$S EhtERGY � W.R.E.C. <br /> [�PLUhABiIVG $ '���1- �� <br /> [�NiECHAMCAL $ VALUATION OF FhECHANfCAL INSTAI.LATION l� n � � <br /> . � <br /> QGAS Q ROOFING Q SPECIAI.TY [� OTHER <br /> FtN1SHEQ FLOOR ELEVATIONS FLQOD ZONE AREA QYES NO <br /> �UILDE� � � C�l�P�3Y _ <br /> �«��+�uRE , REGISTERED Y! N FEE CURREh Y/T1 <br /> �ddr�ss _.�—� • Ltcense# � � <br /> �LEC'Y�I�Ib� COAl�PAAiY <br /> 51GCd/�1�U�E �' REGISTERED Y/ N - F�cu�trteA "Y/N <br /> .�+�de�s� LEcense# �� � ( <br /> ��.u�w��� � con���aY �f..'l��(� � l4'I�I Cl-�'I l�'�1 <br /> ����+�;��� REGISTERED Y/.iV �E cuRt�P Y/N <br /> �a���� `�L �'�'-�'�1 ��VYI u�ense� ��� C�-�' r��� � <br /> ��c��ic�. co���,�nr � <br /> �1������� REGISTERED Y/ IV . FEE CURREP. Y/IV <br /> �d����s License# t �� <br /> O'P@i�R COM��1Y - <br /> �iG��S'�l�R� REGISTERED Y/ 1N _ FE6 CURREn Y/N <br /> Ad�ee� - i.lcense# �� .i.. —.� , <br /> R�S1���91'1�1: Attacti(2)Plot'.Plans;(2)sets of Buildtng`Pfans;(9)set of Energy�Foren§;R=0-UU Permit for new construction, <br /> tViinimum ten{18)workfng days sfter.subrriittal date. -Fteqaireii onstte,Constructian Plans;StormwaEer Ptans w/Silt Fence instalied, <br /> Sanitary Fac[ltt+es 81,dumpste.r,Site UVork Permit€ar subdlv3slonsttarge pr6jecis � <br /> CORfINd�B3�I�L. Attach(3)cbmplete seCs af Building Plans plus a Llfe Safety Page;{1)set of Energ}r Forms.R-O-W Permit�r ne��construc�ian. - - <br /> �Tinimum ten(1d}working days'after subm(ttat date. Required onsite,Construction Plans,Storrttwater Ptaras�f Sit Fence installed, <br /> Sanitaty Facllities&1 dumpster.Site Wotk Permlt for ail new projects.Atl cammercia!regulremenfs musF rraeet campl'rarsce � <br /> SIi3Ri PE�Ml7' P�ttach(2)sets of Engineeretl Plans. _ <br /> °'"•PROPERIY SURVEY required for at(NEW canstruction. <br /> Direc4l�n�: - - � - - <br /> Fiq ouf appiica8on compietely. <br /> Owner�Cantraator stgn bac�of appltcatton,notariaed � <br /> ti cv�r�2580,�4��4Lo�c►F Commenc�m�nk t�r�quleed. (�+tC�pgead�s over�75Q0} . <br /> " t�w��;fcr the contraetor)or Power of A�tomey(for ttte ovmer)would be sorneone vrith notarized tetter from owner autharizing same - ' <br /> �','.._.�;. '-�.v�'�.�t�"�PERR9177i4VG (�ront of A�p!lcatfan Qn{y) <br /> �=:€.`a'�-�ac::.� �:.�.� Senrice Upgrades A/C Fences(Plot/Survey/Footage) <br /> � .�i!�t�s►--n�,'�.«�:......,.�:�"�-:��;,..�:�;r--�,:��,��__rtaedsROW . <br /> �ij'' ,. , .. ' . <br /> . ' � � _ � . : -- '� ,. . <br /> -''f., ,��'r!4�^��° , . ,. � .� ., ' _ <br /> ;,,. .. ... � � , - <br /> a.._ _ _ __.W.._......,_�.__- -..•."�—"--��.._'__" _ - - <br />