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<br />813-780-002U <br /> <br />'-"'J -. --r-- -..I..' . . <br />Building Department <br /> <br />Owner's Name ~e,,;lc~ _I 's <br />Owner's Address ( 310"1:; 5~ Au ~ <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Uieholde' Add,e55 1 . <br />JOB ADDRESS r 3? _ ~7 5+4 <br />I <br /> <br /> <br /> <br /> <br />, <br />Owner Phone Number <br /> <br />Owner Phone Nu~ber i <br />Owner Phone Nu~ber r <br /> <br />Date Received <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br />BLOCK <br /> <br />/}vc- <br />1 <br />B <br />o <br />o <br /> <br />J <br /> <br />LOT # <br /> <br />PARCEL ID#f <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />o <br />o <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />B <br /> <br />PROPOSED USE 0 <br /> <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK I ~~v UfjV"Ci~~ , I <br /> <br />BUiLDING 51ZE I I 50 FOOTAGE I .! _ HEiGHT _I , """""'''''' "l... , " ' " " " """ " " <br />11I1 1111111111111 , III I , II II II III . 1111111111111111111111 , 1 , 111111111111111111111111111 1111111111111111 I <br /> <br />o BUILDING .1$ I VALUATION OF TOTAL CONSTRUCTION <br /> <br />o . ELECTRICAL 1$ I AMP 5ERVlCE :A.o 0 ['2:( . PROGRE55 ENERG:__ 0 __" W_RE_C <br /> <br />o PLUMBING 1$ I . /::. -1 .) <br /> <br />o MECHANICAL 1$ I VALUATION OF MECHANiCAl INSTALLATION li~ I ~ J <br /> <br />o GAS 0 ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111I1111I111111111111I111111111111111111111111111111111111111111I11111111111111111111111111111111111111I111I11I111111I1111I1111111III1111111 <br /> <br />BUILDER I I COMPANY I . I <br />SIGNATURE REGISTERED Y / N FEE CURRENT Y / N <br /> <br />Address I License # I <br /> <br />~~~:~~:Nll---6 ~ ~ - ;:'o~= ~7;;f':..;.!a:~i-P'(YIN I <br /> <br /> <br />Address _ _ License # I I <br /> <br />PLUMBER I COMPANY I <br />SIGNATURE . REGISTERED Y / N FEE CURRENT Y I N <br /> <br />I License # I <br /> <br />I <br />I <br />I <br /> <br /> <br />Address I I License # I I <br />111\111111111111 1 111111111111111111111111111111111111111111111111111111111111111111111111 i III i 1I1111I111111I1 i 111I11I1111I111 j 1111111II1I11I111II1 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms . <br />Minimum ten (10) working days after submittal date. Required onsUe. Construction Plans, Sanitary Facilities & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />"'~PROPERTY SURVEY required for all NEW construction. <br />11.11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111II111111111I1111111111I11111111111 <br />Directions: . <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) <br /> <br />.. Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />OTHER I <br /> <br />Address <br /> <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br /> <br />Address I <br /> <br /> <br />OTHER I <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGiSTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />