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t��py ON;t <br /> 813-780-0020 phyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> X <br /> Date Received <br /> t Phone Contact for Permitting F <br /> 19 <br /> I <br /> ownerSIName Owner Phone Number <br /> -Th <br /> Owners Address Owner Phone Number <br /> Fee Simple Titleholder Name I ry f n Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �—TrQA SUe 4(hals&'bq1 LOT# <br /> SUBDIVISION [Si—welrmo PARCEL ID#1 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN 0 DEMOLISH <br /> R INSTALL 8 REPAIR <br /> PROPOSED USE = SFR = COMM OTHER <br /> TYPE OF CONSTRUCTION = BLOCK Q FRAME STEEL <br /> DESCRIPTION OF WORK G Rem &1111)tA <br /> BUILDING SIZE SQ FOOTAGE® HEIGHT I "I I <br /> . . . . . . . . . . . . . . . . . . <br /> (]BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING IS <br /> =MECHANICAL IS VALUATION OF.MECHANICAL INSTALLATION <br /> =GAS 0 ROOFING = SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> BUILDER rZ COMPANY <br /> SIGNATURE I REGISTERED Y/ N FEE CURREN Y liq <br /> Address r-)L, vs iwe AwB&A Ucense# I 0'VIV N":Motav <br /> L <br /> ELECTRICIAN COMPANY REGISTERED YIN FEE CURREK= <br /> SIGNATURE I _XLN J <br /> Address F_ Ucense#F— 7 <br /> PLUMBER COMPANY = I <br /> SIGNATURE REGISTERED YIN I FEE CURRa <br /> Address License <br /> MECHANICAL COMPANY <br /> SIGNATURE F REGISTERED I Y/ N FEE CURREN LYL/N <br /> Address I License#F_ <br /> OTHER COMPANY = <br /> SIGNATURE REGISTERED YIN FEE CURPEr, Lj I N <br /> Address _1 License#F77 <br /> III 111 111111 11 1 1 1 1 1 If I I It I I I I I I I 1 11111 111 111 $ 111 11 111 still III I I I I <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facilities&I dumpster,Site Work Permit for subdIvislonsnarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page,(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stomweater Plans wl Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> PROPERTY SURVEY required for all NEW construction. <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> It over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />