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813-780-002D City ot �epnyrnnis rer►�u�hNN���a����� <br /> • , . Building Departmenf <br /> Date Received ! 2 r�y � Phone Contact for Permitting ��3 7 �`s. — �s °� <br /> Owner's Name ������ �"e[�- • Owner Phone Number � <br /> Owner's Address �ll'C/� l.L I Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Nurriber <br /> Fee Simple Tltleholder Add�ess <br /> JOB ADDRESS �S 4-/�J�. � �O�Q � LOT � ��7 <br /> SUBDIVISION "l , �Y'�c v� PARCEL ID# �y �-l0 — O� 0 � — ��Q�� od9v <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � � WSTALONSTR e REPAIR � SIGN � MOVE [� DEMOLISH _ <br /> PROPOSED USE � SFR ' 0• COMM 0 OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK � FRAME � 0 STEEL Q OTHER — I <br /> DESCRIPTION OF WORK � Or 7� /��`� � <br /> BUILDING SIZE � 7 u ` 3 � SQ FOOTAGE y76 HEIGHT <br /> BUILDING $�/� Oa VALUATION OF TOTAL CONSTRUCTION <br /> (�C.(/ <br /> � ELECTRICAL $ AMP SERVICE 0 PRO RESS ENERGY Q W.R.E.C. <br /> � � � � �' � � � a�- PERMIT ��F�vIC� <br /> � PLUMBING � � . � ��� <br /> v p�� (813) 788-53 <br /> 0 MECHANICAL $ VALUATION OF ME CAL INSTALLATION �� 1-�-�247� <br /> 0 GAS 0 ROOFING � SPECIALTY � OTHER �`��� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES QNO <br /> BUILDER � ,` �� 1 COMPANY Ol,L'/J Q� <br /> 51GNATURE �. � - REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address 3�t yp � Z J� � . License # <br /> ELECTRICIAN • COMPANY <br /> SIGNA7URE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address � License # � <br /> PLUMBER COMPA�Y <br /> SIGNATURE REGISTERED Y/ N FEE CURREN7 Y/ N <br /> Address License # � <br /> MECHANICAL COMPANY . <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N . <br /> Address License # <br /> OTHER COMPANY • <br /> SIGNATURE R6GISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # �— � <br /> RESID�NTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construcEion, <br /> Minimum ten (10) worl<ing days after submittal date. Required onsite, Construction Plans, Sformwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumps�er; Site Worl< Permit for subdivisionsflarge projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction. <br /> Minimum ken (10) woricing days after submittal date. Required onsife, Consfruction Plans, Stormwater Plans w/ Silt Fence (nstalled, <br /> Sanitary Facilities & 1 dumpster. Site Woric Permit for all new projects. All commerclal requirements must meet compliance <br /> 51GN PERMIT Attach (2) sets of Engineered Plans. <br /> "**"PROPERTY SURVEY required for all NEW construction. � <br /> , �_�_� �_,_��� <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. (A/C upgrades over $5000) <br /> ** Agent (for the contractor) or Power of /Cttorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) � <br /> Reroofs Sewers Service.Upgrades A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />