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813-780-0020 Cifiyol�Gepnyrnius► ��rliu�r - �NN��������� • <br /> • Buiiding Department <br /> Date Received �,.; Phone Contact• for Permittinc� /�� "� __ __ <br /> tHtl - - iN • - " � <br /> Owner's Name L-�- ,��-�� • Owner Phone Number <br /> Owner's Address �3 �� v Owner Phone Number <br /> f-'ee 5imple Titleholder Name Owner Phone Nurriber <br /> Fee Simple Titleholder A�ldress <br /> S�C�-/Jl� � !�-�O-vC� LOT # � . <br /> JOB ADDRGSS . <br /> SUBDIVISION � • � 6� Z � N PARCGL ID# �� °� — �� ` a � <br /> (OI3TAINE� FROM PROPERTY TAX NOTICE) <br /> WORK PROP05ED ' NCW CONSTR ADD/ALT 0 SIGN [� MOVE Q DCMOLIShI <br /> � INSTALL � REf'AIR <br /> PROPOSED USE' 0 <br /> SFR ' C� • COMM � OTHER <br /> TYPG OF CONSTRUCTION � DLOCK �� FRAME '. 0 STEEL � OTHER <br /> DCSCRIPTION OF WORK � X � � � � � —" - � C �� � <br /> BUILDING SIZE O x d SQ 1=00TAGC (,¢ Y 1-IGIGFIT � r r <br /> BUILDING $� j fJ� VALUATION Of= TOTAL GONSTRUCTION <br /> ,� W.R.E.C. <br /> � ELECTRICAL ;� , AMP SL-RVICC 0 PROGRESS �NCRGY Q <br /> � PLUMBING I� � ��Z� JS <br /> � <br /> 0 M�CI-IANICAL $ VALUATION OF MECI-IANICAL INSTALLATION . <br /> � GAS � ROOFING � SPECIALTY � OTHER , <br /> 1=1N1SI-IED FLOOR GLEVATIONS 1=LOOD ZONE AREA [�YES ONO <br /> BUILD�R �� � � COMPANY , �`'� � �J IOA =/�C - <br /> SIGNATURE REGISTERED Y/ N �EE CUftRENT Y/ N <br /> Address � �S �� ` /� !� � ' . Licanse �k <br /> CLCCTRICIAN • COMPANY <br /> SIGNATUR6 REGISTGRCD Y/ N FGE CURREN7 Y/ N <br /> Address � License # <br /> PI.UMBER • COMPANY <br /> SICtiNATURE f{EGISTERED Y/ N F�E CURRENT Y/ N <br /> Address License # � <br /> MECMANICAL ' COMPANY <br /> SIGNATURE • REGISTERED Y/ N �FCE CURRENT Y/ N . <br /> Address • License # <br /> OTHEFt � COMPANY ' <br /> SIGNATURC RCGISTERED Y/ N PE6 CURRGNT Y/ N <br /> Address � , License # � <br /> R�SID�NTIAL Attach (2) Plof Plans; (2) sets of Building Plans; (1) set of Cnergy Forms; R-O-W Permit for new construcfion, <br /> Minimum ten (10) worlcing days afEer submittal date. Required onsite, Copslruc�ion Plans Stormwater Plans w/ Silt Fence installed, <br /> Sanftary Facilities & 1 dumps�er; Site Worlc Permif for subdivisionsllarge projects • <br /> COMMERCIAL Attacli (3) complete sets of Building Pians plus a Life Safety Page; (1 } set of 6nergy Forms. R-O-W Permifi for new construction. <br /> Minimum ten (10) worlcing days after submittal date. Requir�d onsite, Construction Plans, Slormwater Plans w/ Silt Fence installed, <br /> Sanilary 1=acilities & 1 dumpster. Site Worlc Permit for ail new projecfis. All commercial requirements must meet compllance <br /> 51GN PERMIT Attach (2) sets of Engineered Plans.� <br /> ****PROPERTY SURVEY roqulred for all NCW construction. ' • <br /> -I-F-I-I-I-f-1-1-hf-f-I-I-{-I-1-I-1-H+1-I-i-I-I+H-i-1-I-1-1-1-t-1-f-1-I-1-I-1-H-H-H - i - FI - H - t - FI - 1 - hl - 1 - I - 1 - i - } - I -1- h }-1- I -1- I - H - I -1-1- I -1- i -1-1- I - H -I-1-I-(-I-l-1-1-1-1-I-1-hhl-H-H-H-FI-i-H-H-H-l-I-1-1-1-I-I-h{-l-hl-N-li-l-i-i-1-H-1-FI-1-i-I-1-F <br /> Directions: , . <br /> Fill out application completely. ' <br /> Owner & Conlractor sfgn bacic of application, notarized ' <br /> Ifi over $25UD, a Notic� of Commencement is required. (A1C upgrades ov�r $5000) <br /> ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner auEhorizing same • <br /> OVCR THE COUNTCR PERMITTING (Front of Application Only) ' <br /> Reroofs Sewers Service.Upgrades A/C f=ences (PlotlSurvey/f=aotage) • <br /> Driveways-Not over Counter if on public roadways.:needs ROW <br />