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` --' uity ot /ephVrhiU8 Permit Application Fa»813-780-0021 <br /> / Building Department <br /> Date Received r Permitting <br /> Phone Contact fo <br /> Owner's Name nc- owner Phone Number <br /> ' S Owner Phone Number <br /> Fee Simple Titleholder Name F_��bU Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS <br /> w <br /> 8uBDPNSu]N <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED wowcomarx AooA\LT �---1 O\GN F--| �—� ' DEMOLISH <br /> INSTALL �_] REPAIR <br /> PROPOSED USE [--� SFR F--1 COMM F---� OTHER <br /> TYPE OFCONSTRUCTION �—�~ BLOCK [—� FRAME �--1 STEEL <br /> I NJ <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> F--lBU\LDiNG VALUATION OF TOTAL CONSTRUCTION <br /> F--lELE�[RCAL AMP �--\ P���R��G�NERE;/ �—� YY.R.E.C. <br /> �_-- <br /> �—�PLU�B|N� <br /> �--� <br /> 4149 <br /> F--lk�ECMAN|�A� MECHANICAL^__^ . <br /> =GAG ~l ' ROOFING �—l � SPECIALTY OTHER <br /> OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> - - - - - - - - - - - - - - - <br /> BO|LDER COMPANY <br /> SIGNATURE nsoIensnEo L_l��L� rEEuu«RE^ <br /> Address uuunoo* <br /> Eaw,; <br /> ELECTRICIAN ooMP/VVY <br /> SIGNATURE REGISTERED L_21_K_ I rEEc»nRE^ L_ <br /> Address Liponse* <br /> PLUMBER COMPANY <br /> SIGNATURE neGImrsnso L�L1_N_J pesmunnex <br /> Address License <br /> MEcHAm|uA- coMexmv <br /> SIGNATURE REGISTERED ` LVVN J FftECUenFI\» LY/NJ <br /> Address uoonsn# <br /> OTHER compmxv <br /> SIGNATURE nso'areneo LY/_N_J peecueRe^ L_2INL1 <br /> ' <br /> 1 cc <br /> A durean License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(1O)working days after submittal date. Required onshe.Construction Plans S8onnwoter Plans wV Silt Fence installed, <br /> Sanitary ta FaciUtiou&1dumpster;Site Work Permit for subdivisions/large projects _) <br /> � <br /> COMMERCIAL ch )com��ae�sofBuUd\m]Plans plus a Life Go��Pago� � ��(�)aat��sn� �F� o.� -w'Permlt for new construction. <br /> Minimum ten(1O)working days after submittal date. Required onude.Construction Plans,Stormwater P<anmxt�ilt Fence installed, <br /> Sanitary Facilities 81 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered P|bns. <br /> w"PROPERrYSURVEY required for all NEW construction. ' <br /> Fill out application completely. <br /> Owner&Cnntrocor sign back of application,notarized <br /> If over$2ao0,o Notice of Commencement/srequired. (AIo upgrades over*75OO) . <br /> ~^ Agent(for the contractor)or Power of Attorne�(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy ofcontract required) <br /> Ramofs if shingles 8ewora Service Upgrades A/C Fnnces(P|oVDumey/Fnota8e) . <br /> - <br /> Driveways-Not over Counter ifon public medwayo..needaROW ' <br /> i <br />