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— '--' UllyDT4epnV[hU\GPermit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received (A-SID <br /> Phone Contact for Permitting C <br /> Owner's Name Owner Phone Number <br /> Owner Phone Number F <br /> owner's Address Ott 33 <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> ousoNISxzN PARCEL ID# <br /> . (OBTAINED FROM..~.E..TAX NOTICE) <br /> ` <br /> WORK PROPOSED mowcowsrn AoD8\LT �--� SIGN [--| F--) DEMOLISH <br /> E5 INSTALL E REPAIR <br /> PROPOSED USE = ' aFR �—� COMM �--1 OTHER <br /> TYPE OFCONSTRUCTION ��� BLOCK F—� FRAME �--� STEELBUILDING SIZE SQ FOOTAGE HEIGHT <br /> F--| <br /> DESCRIPTION OF WOR K �51mlo_ rnwJ14 neslafnLL L2410 J.—A <br /> ' <br /> =BU ILDING VALUATION OF TOTAL CONSTRUCTION <br /> �—�ELEOT�CAL AMP SERVICE F--� PRDGREGSENERGY �—1 VY.R.E.C. <br /> ���� <br /> =PLUMB!NG <br /> =MECHANkCAL ' J$ VALUATION OF MECHANICAL INSTALLATION <br /> F����--lGA8 Fu]OFlN� �—| � OP�C�l3Y | | OTHER <br /> �—� �--^ �—^ �--� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YEs NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED 'EftmIRRE� L��__j <br /> Address Uuon u# <br /> ELECTRICIAN cump*m, <br /> SIGNATURE Y N rEEo`nRE^ Lr/N � <br /> . <br /> Address License# <br /> PLUMBER cuM*Amr <br /> SIGNATURE nEo/orsneo [_yi_N_] 'FcscunR�Itx L_ 2­L� <br /> Address License# <br /> MECHANICAL COMPANY Pr0q"5s`1,,J-e_ <br /> SIGNATURE L12 REGISTERED ^ L� N_ Fssou*neN [LL/NL_J <br /> Address ) License# <br /> OTHER compmx, <br /> SIGNATURE nsG/arsnso L_YLN_I psscunns^ L_Y_LNL_J <br /> ' <br /> Addeas Licanoo# <br /> muxxuxxmxxxumxxxxmxxxxm ^Uxoxx �� nxnxu8uuuxnmnuummxuxKUmuunm � xxxmmVxxn <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;F-O-W Permit for new construction, <br /> Minimum ten MNworking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Slit Fence installed, <br /> Sanitary Facilities&1 dumps(ac Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)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,Stormwater Plans w/Slit 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 p|ans. <br /> **~°PROPEFTY SURVEY required for all NEW construction. ' <br /> Fill out application completely. <br /> Ovmer&Contractor sign back of application,notarized <br /> n over*2sn0,a Notice or Commencement isrequired. (/oo upgrades over$r5oo) <br /> � Agent(for the contractor)or Power of Att6me�(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Remofs|fshingles 8ewes Service Upgrades A/C Fencem(P|oVSumey/Footagn) <br /> Dhvmways�otuverCuun�r�onp��umadwaya..noedoROYV <br /> __---__ <br /> . ` . . <br /> \ <br /> \ - <br />