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<br /> <br />-~-IJ <br />. EdWiAJ /ViMK l<icHB.te.. <br />Q .Jh <. <br />Owner's Address 6100 ~O. vfreR.~f; ZepAy,-h~l/s <br />Fee Simple Titleholder Name I <br /> <br />Fee Simple TItleholder Address 1 <br /> <br />16/05 d-OM Sfre_e-r.) ~.e-phyrhdls) FL <br />I Zephyr B"e~.z.e- <br /> <br />813-780-0020 <br /> <br />. . <br />D~ Received <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCnON <br /> <br />DESCRIPnON OF WORK <br /> <br />BUILDING SIZE <br /> <br />BUILDING <br /> <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br />D GAS <br /> <br />Phone Contact <br /> <br />F.+x: <br />(?6a)68~- <br />07::17 <br /> <br />Owner Phone Number J' /:3 - 7 3 ~ - ;)..?- If '7 <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number 1 <br /> <br />E3 <br />D <br />D <br />I ((e-roof <br /> <br />1 <br />E3 <br />o <br />o <br /> <br />33S-'l~ I LOT' 1 <br /> <br />PARCELIDtI 0 J.-)..h-~-O J 9()-OOOOO -0/00 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 <br /> <br />/0 <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />BLOCK <br /> <br />o <br />C8J. <br />o <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />OTHER I RE-ROOF (5h/~/L) <br />STEEL 0 OTHER I <br /> <br />SQ FOOTAGE I ;'t/ 00 <br /> <br />HEIGHT I <br /> <br /> <br /> <br />VALUATION OF TOTAL CONSTRUCTIO <br /> <br />.--' <br /> <br />1$ <br />1$ <br />1$ <br />~ <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />- <br /> <br />I <br />I <br />I <br />o <br />I <br /> <br />DNO <br /> <br />AMP SERVICE 0 <br /> <br />W.R.E.C. <br /> <br />~/()ahCYZ o-f <br />l<e-rct)f:t.J,u;o~ ~ <br />.:1-5"/08. BO <br />I <br />(02/Srre-s) <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />SPECIAL TV D OTHER <br /> <br />FLOOD ZONE AREA DYES <br /> <br />rr r r ""J <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <br /> License . <br />Y/N FEE CURRENT <br /> License # <br />Y IN FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br />/ /<D.OF/I()6- ) <br />~ OTHER <br />SIGNATURE <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />Address <br /> <br />License # <br /> <br />1&C"53()~ " <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br />Minimum ten (10) wortdng days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Wol't( Permit for subdivisionsllarge projects <br />Attach (3) complete il8&LDf.Building Plans plus a Life Safety Page; (1) ~t of Energy Forms. R-O-W Permit for new construction. <br />Minimum ten (10) wortdng days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Wol't( Permit for all new projects. All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans. <br />-PROPERTY SURVEY required for all NEW construction. <br /> <br />RESIDENnAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, . Notice of Commencement Is required. (Ale 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 NC Fences (Plot/Survey/Footage) <br />Driveways-Not over Counter if on public roadways..needs ROW <br />