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813-780-0020 VIL�/ OI LC�JI Iy� ������ � �� ��••. .-r r <br /> Building Department <br /> Date Received ° ~ Phone Contact for Permlttin � <br /> ,,. � T � ` G � e <br /> Owner Phone Number � � Q - �' � � - � G � <br /> Owner's Name <br /> T � _ l� Owner Phone Number � <br /> Owner's Address Z �� C�� "�' � <br /> =Y'L,��-���� c' ( a Owner Phone Number <br /> Fee Simple Titleholder Name <br /> Fee Slmple Titleholder Address � <br /> �v � Z. � � �-1-[ �Z. �--i i � � S <br /> � l LOT # <br /> JOB ADDRESS 3� �' � `��� <br /> PARCEL ID# � � ` � � ^ Z � <br /> o v � C� �f ct C� U O� �� <br /> SUBDIVI310N . (OBTAINED FROM PROPERTY TAX NO ICE) <br /> SIGN MOVE DEMOLISH <br /> WORK P120POSED e NEW CONSTR e REPAIR � � <br /> iNSTALL <br /> PROPOSED USE � SFR 0 COMM � OTHER <br /> TYPE OF CONSTRUCTION 0 <br /> BLOCK 0 FRAME Q STEEL Q OTHER <br /> DESCRIPTION OF WORK C�e '�Q � <br /> BUILDING SIZE <br /> �_� SQ FOOTAGE HEIGHT <br /> � BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> � ELECTRICAL $ <br /> AMP SERVICE �] PROGRESS ENER Y Q W.R.E.C, <br /> Q PLUMBING $ <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> � GAS <br /> � ROOFING 0 SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES QNO <br /> V U't + `-i �1J <br /> COMPANY U`�'"�'�` FEE CURR NT Y/ N <br /> BUI - REGISTERED Y / N <br /> TURE 1 � t_.-+ <br /> License # <br /> Address <br /> COMPANY <br /> ELECTRICIAN REGISTERED Y! N FEE CURRENT Y! N <br /> StGNATURE <br /> License # <br /> Address <br /> COMPANY <br /> PLUMBER REGISTERED Y/ N FEE CURRENT Y/ N <br /> SFGNATURE <br /> Ucense # <br /> Address <br /> COMPANY <br /> MECHANICAL REGISTERED Y/ N FEE CURRENT Y 1 N <br /> S!G NATU RE <br /> License # <br /> Addrass <br /> OTHER R O ED Y/ N FEE CURRENT Y/ N <br /> SIGNATURE <br /> License # <br /> Address <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fortns; R-O-W Permit for new construc on, <br /> Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater PI ns w! Silt Fence installed, <br /> ,.__.._.., �.,,.s��+io� x��tumoster. Stte Work Permit for subdivisions/large projects __^^+. ^��^^ <br />