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--- uity otZephY[h\Ug Permit Application Fax-813-780-0021 <br /> Building Department <br /> D�e' eceived hone Contact for Permitting <br /> Owner'sName Ila. n c- 1 ' ' OwnerPho'ne Numbe'r <br /> Owner's Address <br /> pa Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS <br /> FoUoowoSu»N xz# <br /> (OBTAINED IiROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED mowcomsTn AoDA\LT F--� S|GN �—� �—1 DEMOLISH <br /> Ef INSTALL F_] REPAIR <br /> PROPOSED USE F--� opR F—� COMM [---� OTHER <br /> TYPE nFCONSTRUCTION F—��' BLOCK �—1 FRAME F---1 GTEELBUILDING SIZE SQ FOOTAGE HEIGHT <br /> DESCRIPTION OF WORK <br /> ' <br /> �__]BU|LD|NG VALUATION OF TOTAL CONSTRUCTION <br /> F--lELE[TR|[AL AMP SERVICE [--1 PRDGRESSENEREY �--1 vV.R.E.C. <br /> F--7PLUMB|NG <br /> � ^� <br /> =MECHANlCAL MECHANICAL INSTALLATION ~ <br /> =GAG ROOFING F—� � SPECIALTY [---1 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA <br /> i__�YE8 NO <br /> au|LoEm COMPANY <br /> a|GN�U�� REGISTERED I' rescunnsx N1 <br /> Address License# <br /> Eaco,�9 c�' 2 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE nsa/aTEnso Nr_]` FsEcunns^ ylN�_1 <br /> Address # <br /> PLUMBER COMPANY <br /> SIGNATURE neo/orsnso 'FsstunxEN <br /> Address Uconao# <br /> MECHANICAL COMPANY <br /> SIGNATURE nea/nrERso FtsounnEN`J <br /> Address <br /> OTHER COMPANY <br /> SIGNATURE <br /> nsm/enseso �lY_m_� rcsoumnEx <br /> I cc <br /> Address License# <br /> RESIDENTIAL Attach(8 Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, � <br /> Minimum ten(1u)»mrking days after submittal date. Required nnsiha.Construction P|an�,Stann*ate,Plans vl Silt Fence installed, <br /> Sanitary Facilities&1 dumputer;Site Work Permit for subdivisions/large projects _� <br /> COMMERCIAL At�ch(2)complete a�nnfBuUding Plans plus a��So��pago��)set ofEne�yFv6�u.R,O-WParmit for new construction. <br /> Minimum ten(1O)working days after submittal date. Required nno\to.Construction Plans,Bhormwater Plans vl§i\t Fence installed, <br /> Sanitary Faci|itios&1 dumpster.Site Work Permitfor all new projects.All commercial requirbment5 must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. ' <br /> °'PROPERTY SURVEY required for all NEW construction. <br /> Directions- <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$26nV.n Notice of Commencement|*required. (AIc upgrades over*T5VO) . <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 of contract required) <br /> Rmnofsifshingles Sewers Service Upgrades AIC Fencem(P|ottGumey/Fontage) <br /> � <br /> Driveways-Not over Counter ifon public mndways..neodnROW ' <br /> ! <br />