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City OfZeohV[h(U8Permit Ann\\CEtiOn Pox-813-780-0021 <br /> Building Department <br /> � . <br /> Date Received 1Phone Contact for Permitting Qi(\k_n& CAV-korfto, com <br /> Owner's Name HP003 linc Owner Phone Number <br /> Owner's Address <br /> 3�1 3�L Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS [5tQct 33" LOT# <br /> SUBDIVISION PARoEI OD# <br /> ' (OBTAINED FROM PROPERTY TAX~"= <br /> VxORKPROPooEo wEwcumuTn AooV\LT �--1 SIGN F--1 �--| DEMOLISH <br /> E!� INSTALL E REPAIR <br /> PROPOSED USE �—1 ' aFR [—� COMM �--� OTHER <br /> TYPE OF CONSTRUCTION ' BLOCK F-� FRAME �--� STEEL F--� <br /> BUILDING SIZE SQ FOOTAGE 9-13 kk-+f-. HEIGHT <br /> �—��U!Lo|NG <br /> �—� VALUATION OF TOTAL CONSTRUCTION <br /> =ELECT0CAL AMP SERVICE �--1 PROGRESS ENERGY �--1 VV.R-E.C. <br /> F--lpLUMBiNG <br /> �--��EC�AN|�AL MECHANICAL <br /> ___ <br /> �—��8S ��� ROOFING �—! � [—�| w�- �� <br /> H <br /> --- --- SPECIALTY OTHER ' Nw� <br /> F <br /> FINISHED FLOOD �—�YES NO Q w <br /> �_-� � <br /> BuKoBm COMPANY <br /> SIGNATURE REGISTERED LY/ N pEI�nunnE� LY/ �� <br /> Address Uconen# <br /> 2- <br /> ELECTRICIAN if compAmr <br /> SIGNATURE LY/ N pEEo»RREN LY72NJ <br /> Address License# <br /> PLUMBER > COilPANY <br /> SIGNATURE REo/aTenEo LY/ N 'FssounKdx L���L� <br /> Address License# <br /> MECHANICAL COMPANY PV_0qvv-55`1Q,0 <br /> SIGNATURE REGISTERED , L����� pesounnEN [LY/NLJ <br /> Address 3 License# <br /> OTHER COMPANY <br /> SIGNATURE meo'orsnEo LY2 lN_ rsecunREN L_y LNL_fJ <br /> ' <br /> Addmos License# <br /> xmnmxoxmmxxxnmxxxxn � xxx� VVUoxnVxxnum � xxuKmmxuxVmnxuUVUxx0 � nnxxm � � nx <br /> RESIDENTIAL Attach(2)Plot Plano�(2)sets of Building Plans;(1)set of Energy Forms;R-}4m Permit for new construction, <br /> Minimum ten(1O)working days after submittal date. Required orisite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpotor;Site Work Permit for subdivio1ons8angeprojects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus o Life Safety Page;(1)set nf Energy Forms.R'O-W Permit for new construction. <br /> Minimum ten(1U)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&I dumoster.Site Work Permit for all new projects..All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(0 sets uf Engineered Plans. <br /> °°°°PROPERTY SURVEY required for all NEW construction. ' <br /> Fill out application completely. <br /> Owner&Contractor sign back nf application,notarized <br /> If over$2sou^e Notice cx Commencement isrequired. (4/C upgrades over*75VD) <br /> °^ Agent(for the contractor)or Power of Attorne�(for the owner)would be someone with notarized letterfrom owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> RomofsKshingles 8owam Service Upgrades A/C Fanoeo(P|nVSuwey/Footage) <br /> Driveways-Not over Counter ifon public mod*aya..noedoROYV <br /> ' ' <br /> ' <br />