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~^''""_Vv4" City mfZeohY[hiUG Permit Application Fo»813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> Owner's Nam Owner Phone Number !j�jq 19(0 <br /> e C— <br /> T3S Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> ' <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# <br /> SUBDIVISION (OBTAINED FRIDM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> Ef' INSTALL REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK F �;w ex z, aeennL 7- a <br /> BUILDING SIZE ________ ` <br /> =BU|LD|NG VALUATION OF TOTAL CONSTRUCTION <br /> =ELECT0{:\L AMP SERVICE [--� PROGREOSENERGY F--1 VV.R.E.C. <br /> =PLUMB|NG <br /> =MECHANkCAL <br /> ' VALUATION OF MECHANICAL INSTALLATION <br /> G�� r��/ ' ROOFING <br /> SPECIALTY OTHER <br /> OTHER <br /> �--� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES No <br /> BUILDER COMPANY <br /> SIGNATURE neGImrEneo LLL�_J ~E=C"""=" L__j N_J <br /> Adumao umwnan# <br /> [:a COA 9 C�Q*l 2 <br /> =-LEcTRICIAN comp*mr <br /> SIGNATURE nso/sTsnso LY I_N1 Fescuxxe^ <br /> Address ucenae# <br /> zLUMBER COMPANY <br /> 8oNAJVRE msoISTesso LY/ N i pescunwEN L_2IN_� <br /> Address License# <br /> NECHANICAL COMPANY <br /> 3|oN4JURE mEomrExso ` L�Y/'N_ I psscunRsx» LY/NL� <br /> Address License# <br /> )THER COMPANY <br /> �\oNATURE Rsouneeso LY/ l rseuunnsx LY NL1 <br /> Address License# <br /> ZES\DE0TAL Attach(2)Plot Plans;'(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(1u)working days after submittal date. Required unnUe.Construction P|ens..8\onnwm0ar Plans v/Slit Fence installed, <br /> Sanitary Facilities&1 dumpoter;Site Work Permit for subdivisions/large projects _) <br /> ,O88MERC\AL Attauh;g complete sets of Building Plans plus a Life Safety Page;(1)set ofEnargY_Forms.R,64NPennit for new construction. <br /> Minimum ten(1O)working days after submittal date. Roqu\mdnneitu.Conmhoctinnp|ano.StonnvaterPlonayWq\)tFmnoo|natal|od` <br /> Sanitary Facilities&1 dumpstec3iheWorkPonnitfora|\ne*pn4octo.AJ\commancio|nequirbmentsmuotmeetnnmp|ionue <br /> VGNPERM|T Attach(2)sets of Engineered Plans. <br /> °"PROPERTY SURVEY required for all NEW construction. ' <br /> "n,pzmqo: <br /> Fill out application completely. <br /> owner&Contractor sign back of application,notarized <br /> If over$2sno^amvdve of Commencement is required. (VC upgrades ovnr$J5OU) <br /> " Agent(for the contractor)or Power of Attorne�(for the owner)would be someone With notarized letter from owner autho <br /> rizi,ng same <br /> x/ERTHE COUNTER PERMITTING (copy ofnontactrequired) <br /> 'emnfs if shingles Gm*oro Service Upgrades A/C Fonoom(Plot/Gur/ey/Fuotago) <br /> Driveways-Not over Counter ifon public medvayn'neogsROW <br /> ' <br /> ` <br /> ' <br />