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'-- �,;ItyctZ8phYrhi\\8 '^ it Application Fo»813-780-002 <br /> Building Department <br /> Date Received �A510�tiu (M <br /> F Phone Contact for Permitting <br /> Owner's Name Owner Phone Number <br /> Owner's Address 3�S /—'Owner Phone Number <br /> Fee Sonple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB AomRema <br /> SUBDIVISION n)# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW COmSTR F7 AmDIALT z|Gm �� � �� DEMOLISH <br /> INSTALL �_] REPAIR <br /> PROPOSED USE �--� oFR F—� COMM . ---\ OTHER <br /> TYPE OF CONSTRUCTION BLOCK �—1 FRAME F---| GTEEL <br /> DESCRIPTION OF WORK to ni CIO ca- <br /> BUILDINGSIZE SQ FOOTAGE HEIGHT <br /> —rlr—r a A A a A A I D��� . A . . I . A A X A <br /> =8U(LD\NG VALUATION OF TOTAL CONSTRUCTION <br /> �--lELECTRICAL �--\ PROGREGSENERGY [—� YY.R.E.C. <br /> � <br /> =pLVM8\NG <br /> �--� ' ' \��T�LLATDN <br /> �_�,�. ,,~`~� ,,�,' ..~,�. MECHANICAL ' <br /> ,_`� ' <br /> �--lG/VS i��� 'ROOFING �—� ' SPECIALTY OTHER <br /> OTHER <br /> FINISHED FLOOR ELEVATIONS SR 4-6 FLOOD ZONE AREA F_]YES NO <br /> BUILDERCOMPANY <br /> SIGNATUREREGISTEREDp0,��' Fsscunnsx [�N] <br /> Address # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE nsoiaTsnso ^ rsEounnex � I YIN <br /> Address <br /> PLUMBER COMPANY <br /> SIGNATURE nsaIensnso 'FEEtunneN <br /> 1 Address License <br /> MECHANICAL COMPANY <br /> SIGNATURE nEa\nTsnso � ptsnuRREN'\J� <br /> Address <br /> OTHER COMPANY <br /> SIGNATURE REa\oTenso Y1 N psscunnc* — <br /> xu4mos License <br /> m`u u u n 1 n x u x I'll x <br /> RESIDENTIAL Attach(2)Plot Plans;(2)oetsofBuKdingPlano;(1)ootofEnargyFonnm;R-O4YPonnitfornewcdnobocbnn. <br /> -Minimum ten(1V)working days after submittal date. Roquiredono\tn.OonpdmoUnnp|a�s,8tonnwmtorP|anav/Gi|tFence\nstaKod. <br /> Sanitary Facilities&1dumpater Site Work Permit for subd|viaiuris/lacgeprojects _} <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fo-r-ms.R-O-WIFermit for new C onstruction, <br /> Minimum ten(1O)working days after submittal date. Required onuite.Construction Plans,Gho Plans v/8i|t Fence in�a|\od. <br /> Sanitary Fa�\�es&1dumpoto:Site YVonkPann�for all new pnge�o.fA\commen�a|oqu|h»mant�must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered P\iano. <br /> °°°°PROPEpTY SURVEY required for all NEW construction, ' <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2SV0,a Notice ofoomionnnamentinrequired. (VC upgrades over$75VQ) ` <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 /> Romofsifshingles Sewers Service Upgrades A/C Fencas(P|ot/Sumey/Fuotagn) <br /> Driveways-Not over Counter ifon public modvayo..nnedoROW ' <br /> ! <br /> - <br />