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81�7��� <br /> [ City of i|b; Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> n 13 52L� <br /> one Contact for Permitting L <br /> Owner'sName Owner Phone Number <br /> Owner's Address --Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# <br /> SUBDIVISION PARCEL <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED mowcowSTn ADoo\cT �--1 �xsw F--7 �—� DEMOLISHL_J INSTALL REPAIR <br /> ---- --- --- <br /> pROPmGsoWSs F—� GFR F—1 COMM [---1 OTHER <br /> TYPE OF CONSTRUCTION F—� BLOCK �—� FRAME 'F^�—� STssL [--1 <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SO FOOTAGE HEIGHT <br /> F--lELECTRICA AMP SERVICE ' �---1 pnOGnsa8EmEnGY [--1 Vxn-EC. <br /> ` <br /> --' <br /> PLUMBING <br /> =MECH*mICAL VALUATION OF MECHANICAL INSTALLATION <br /> � <br /> [--loxS �-7 ROOFING F—� SPECIALTY OTHER <br /> VT*sR <br /> FINISHED FLOOR ELEVATIONS FLOOD �' mE* F—�v�8 N� <br /> � <br /> BUILDER 6mPANY <br /> Address License# F <br /> ELECTRICIAN COMPAUY <br /> Address unensu# <br /> PLUMBER <br /> nea/arsmED [_Y/ N1 esounne^ ILRI | <br /> Address unenao# <br /> MECHANICAL oqmpwmr <br /> SIGNATURE REGISTERED Y/ NL FEsnonee L���_J <br /> Address L umyme# <br /> OTHER COMPANY <br /> SIGNATURE neomens L_I��L_] eEcunnEN L���_] <br /> Address uoomm# <br /> xxmxxoxnxmuuwnnnmnuunnxmonxmxnuonumnnmnoxnuxmmnumnnmwnnwnxomnuwxxon <br /> RESIDENTIAL Attach(2)Plot Plans;(o)sets u[Building Plans;(1)set o[Energy Forms;R-O4VPermit 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&Idumpotec Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus uLife Safety Page;(1}set ox Energy Forms.R'O4m Permit for new construction. <br /> Minimum ten(1n)working days after submittal date. Required vnoda.Construction Plans,8mmowater Plans xw Silt Fence installed, <br /> Sanitary Facilities&1Uumpoter.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets vf Engineered Plans. | <br /> �*PROPERTY SURVEY required for all NEW construction. <br /> Fill out application completely. <br /> owner&Contractor sign back u[application,notahznd <br /> if over$25o$.a Notice of Commencement iwrequired. (wC upgrades over$7moo} <br /> � Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authodzing same <br /> OVER THE COUNTER PERMITTING (copy vy contract required) <br /> mamvlsnshingles Sewers Service Upgrades A/C Fenxma(qmtSurveyxFomaga) <br /> ` <br /> Driveways-Not over Counter xon public roadways..needs Rovx <br />