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813-78043020 City of Ze phyibills P6rmit Application Fax-813-780-0021 <br /> Building Department <br /> �2 <br /> Data Recehied Phone C*nt3d for Permitting ,F 3/3) ;"o ? - <br /> a n a a a a a 4 a 9 <br /> ownees Nam ell nw-a-M, Owner Phone Number715-- <br /> '4 <br /> OwneftAddressl '3760d eavey T?i11/6"Vllk Owner Phone Number <br /> Fee Simple Tiffebold"Name r Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS L-5:71g,06 IXORRV A:PbJi61ke— LoT# <br /> SUBDIVISION PARCEL IDS �5 AJ &/M e2:>'Q'X 1:2190 <br /> (09MADIED FROM FROPERrY TAX N071GE) <br /> WORK PROPOSED NEW CDNSTRI�ADD/ALT SIGN 71 DEMOLISH <br /> R INSTALLREPAIR <br /> PROPOSED USE 0 SFR = COMM OTHER I <br /> TYPE OF CONSTRUCTION BLOCK = FRAME Q STEEL <br /> DESCRIPTION OF WORK 1AP6,lve'- 6.2ao-1 xa^-( 14oM AMOV71' <br /> 0 <br /> BUILDING SIZE Sa FOOTAGE HECHT <br /> . . . . . . . . . . . . <br /> "EBUILDING 1$ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL 1$ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PWNSING Is <br /> W-MECHANICAL VALUATION OF MECHANICAL INSTALLATION <br /> =CAS 0 ROOFING E:] SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS —1 FLOOD ZONE AREA =YES NO <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4WI."1 <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURRE1% <br /> Address License# <br /> ELECTRICIAN COMPANY = <br /> SIGNATURE REGISTERED I YIN I FEECURM LyjNj <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURREK <br /> Address License#F--- <br /> ME ICAL(� COMPANY SI=it. <br /> REGISTERED I YIN FEE CUMEK I YIN I <br /> Ad. 't7�W— Lloense# <br /> OTHER COMPANY = <br /> SIGNATURE F REGISTERED I Y/ N FEE CIJRFten <br /> Address License <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans,(2)sets d Building Plans.(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ton(ID)woddng days after submittal date. Required onsite,Consbuction Plans,Stormwater PWmvd Sift Fence installed, <br /> San"Facilities&I dumpstor,Site Work Permit for subcfMsionsRarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Plane plus a Ufa Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Wmimurn ton(10)waft days after submittal date. Hawked onske,Constnichon Plans.Starmwater Plans vd Silt Fence installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all raw projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engweared Plans. <br /> —PROPERTY SURVEY required for all NEW construction. <br /> o '­ * 6 . . . . . . . . . . . . . . . . . . . <br /> Directions. <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a-Nofice of Commencement Is required (AIC upgrades over$75W) <br /> Agent(for the contractor)or POW Of Attorney(for the owner)mould be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of&r&ad required) <br /> Remolsifshingles "Sewers Service Upgrades AfC Fences(PIcUSLuvey/Foolage) <br /> Driveways-Not over Counter If on public roadways-neads ROW <br />