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a�saso-oo2o Ci of Ze h rhilis Permit A lication Fax-813-780-002"'�- <br /> tY p Y Pp , <br /> Bufiding Department �:�r <br /> Date Received �� � phone Contactfor Permitting $� 3 y �G __ 03 d3 <br /> r� <br /> rr'r ' . <br /> ` q n �°`. � <br /> Owner'sName h�NMA� �OM�� OwnerPhoneNumber �.27� ��7'��/�� <br /> I�f"S'SO L�6�/Ti.�gvE #� �i,6qRl�4 `G erPhoneNumber [ � <br /> Owner's Address ' <br /> Fee Simple Titleholder Name �— � Owner Phone Number � � <br /> , <br /> Fee 8lmple Titleholder Addreaa � " � <br /> r <br /> JOB ADDRE3S ���1�' �✓�� Z E�H �ChrIGL�,S , FG .�3 S�� �OT # �� <br /> �/L /q/V ,n PR/�' �7+�R'LI PARCEL ID# vJ '��Q -oZ l— Qz�D - OC��X�' IO�- �' N <br /> SUBDIVISION t <br /> (OBTaNED FROM PROpERN TAX NOTICE) � <br /> WORK PROP03ED � NEW CONSTR 8 ADD/AlT C� SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE O SFR Q COMM � OTHER i <br /> TYPE OF CONSTRUCTION � BLC�CK Q FRAME 0 STEE� Q <br /> DESCRIPTION OF WORK N�� �ONSTi4 CT/D�/ " VfL`�S _ i <br /> BUILDING SIZE � SQ FOOTAGE U HEIGHT SGL cS � '��� <br /> �BUILDING $ � � � VA�UATlON OF TOTAI CONSTRI,�T'ON � ' ` �: <br /> QELECTRICAL $��20 � bO AMP SERVICE � PROGRESS EMERGY �` ,n� R=,n,.` <br /> �PLUMBING $ a 5� . OO , <br /> �MECHANICAL $ 2� � VALUATION OF MECHANICA� INS`�Ltr`T104 ° <br /> �� <br /> ;d <br /> QGAS � ROOFING Q SPECIAITY �J OTHEK <br /> F�NISHED FLOOR ELEVATIONS � FLOOD ZONE AREA �"ES NO <br /> BUILDER COMPANI' �����' �" �'� � <br /> SIGNATURE REG�EttE� Y/ N � e Y 0 <br /> Address � Sss� LI �(. �?IO GCFN�N FL 3?7� � �cense = t,. t7 �i �sl 8� ls �o <br /> ELECTRiCIAN COMPANY ���o+�S�l �LKT��G ,�TNC • � <br /> SICiNATURE aec�s7er�C Y 1 tv �� oua�Er� Y' N ' <br /> Address /03y .S'X/P . �AM �0 jG 33LI �,cense ;. ` �COOD.?.s <br /> PLUMBER COMPANY ��"[ W pL V�'� � <br /> SIC3NATURE �EGISTEREC i Y U =Ec : J�e ff. <br /> Address �327 N E `.�3578 � cense = CFC 0.Z t s� � <br /> MECHANICAL ' COMPANY I3A�/ONET �✓��w� / �F��� . � QC <br /> SIGNATURE I REGISTEREC Y � =EE �:�RE� '°' <br /> Address p �� 80x � ONFT �o/NT LL ��'G � = i��Q,S $�� 2 � ! <br /> i <br /> OTHER COMPANY C Sr'fRt�a� ��G/ry �oe�'ir��L� �iutC> � ; <br /> SIGNATURE REGtSTERED Y I'v F� ctr�,. Y��1 ! <br /> � /+ / <br /> Address N�// .S pA UNE BL.A�D as lI�I` f�lGl D7 :i;,ense r j� t„ ^ C I� S'� nj g/ # <br /> 111111111111111111111111Ellllllllllititliltlllili11111Jttil1111fii1 <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Build+ng Plans, (1) set of Energy Fomis, R-C-'J� permit for new cor•strucao- <br /> Minimum ten (10) working days after submittal date Required ensite Constr�c c� ��ans Stor.�wace{ �'�r= ;, S{r =�-_e °�_��� <br /> Sanitary Facilities 8 1 dumpster; Site Work permit for subdivisions/large nrolects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a L'rfe Safery Page; (1) set of Ene•�y Forms R-0-v�r �err�;r, Ea nev. ;.c s: <br /> Minimum ten (10) worlcing days after submittal date Required onsite, Construc::en Pians Stormwater Rta�s w+ Sitt F�.r„� ��� <br /> Sanitary Facilities 8� 1 dumpster. Site Worlc Permit for ail new projeds Ail comr^erci2l reqwre?rerrts msst �n� oo�:e <br /> SIGN PERMIT Attach (2) sets of E�gineered Ptans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . _,_._ �_ , . . . . , , . s.,� <br /> Directions: <br /> Fili out application completely <br /> Owner & Contractor sign back of appGcatior, nctarized <br /> If over $2500, a Notice of Commencemen4 is required. (A,'C upgredes ove� 5750C <br /> " Agent (for the contractor) or Power oi Attomey (for the owner, wouid be someo�e w^;r - �,zr:� _ = = - -= _- ' _ _ � _ __ _ <br /> OVER THE COUNTER PERMITTING (From of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A!C Fences (PIoUSurvey/Footagei <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> � <br />