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813-780-0020 City o1��epnyrnn�s ��c:ttni�HNN����«�,� � <br /> • Building De�artment <br /> Date Receivecl -, ,. �a/ phone Contact for Permitting ��� �_�n°_ ��/� _ _ <br /> 'f-11'I'1'I'li-hhl'1 - -- '111'1 - <br /> Owner's Name (1�u/'2 ��t-��L � Owner Phone Number <br /> Ownor's Address f 77� � /!Q� � � Owner Phone NumUer <br /> Fee Simple Titleholder Name • Owner I�hone Nurriber <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �7�� �'"" � � ~�" � LOT� `� <br /> SUBDIVISION ' . f �/?�' ►�l� �� PARCGL ID# �3-02-�►-�D.!!0- OGL't".�'J-0��3U <br /> . �_, � �OI3TAINE�FROM PROPERTYTAX NOTICC) <br /> WORK PROP05ED ' N�W CONSTR � ADD/ALT ]� SIGN 0 MOVE Q DCMOLISH _ <br /> � INSTALL I�CPAIR <br /> PROPOSE�U5E' . � SFR ' �� • COMM � OTHER ' <br /> TYPG OF CONSTRUCTION 0 f3LOCK � FRAME � ,0 STEEL 0 OTHER <br /> DGSCRIPTION OF WORK . ���� rD�� � <br /> BUILDING SfZE f/ X�/ 5Q f=00TAGE � � I-IEfGI-IT <br /> ' � BUILDING � i/���. l� VALUATION 01=TOTAL GONSTRUCTION , <br /> 7' <br /> 0 ELECTRICAL � , AMf'SCRVICC 0 PROGRESS�NCRGY Q W.I�.E.C, <br /> 0 PLUMBING a� PA.SCO PERMIT SERVIC� <br /> � (813)788-5314 <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL lNSTALLATIOf� .F�1"�8-824-7894 <br /> / (�Z <br /> � GAS 0 ROOFING � SPECIALTY 0 OTHER , �` �� <br /> 1=1NISI-IED FLOOR CLEVATIONS �� 1=LOOD ZONE AREA [�YCS ONO <br /> BUILDGR /'� /�+� '� ' 0 � COMPANY J r _�^� ' <br /> SIGNATURE �u�Ci•—� REGISTERED Y/ N fEE CIJRRBNT Y/N <br /> Address (L/S 0/`I ' . License�# <br /> GLCCTRICIAN • COMPANY <br /> SIGNATURB REGISTGRG� Y/ N FGE CURRENT Y/N <br /> Acldress � License# <br /> PI,UMBER • COIV�PANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Add�ess License# I <br /> MECHANICAL • ' COMPANY . <br /> 51GNATURE REGISTERED Y/ N FEE CURRENT Y/N . <br /> Address .License# <br /> OTHGR � COMPANY ' <br /> SIGNA'i'URC RGGISTERED Y/ N fEE CURRENT Y/N <br /> Address , License# � <br /> RCSID�NTfAL Attach(2)Plof Plans;(2)sets of Building Plans;(1)sel of Cnergy Forms;R-O-W Permlt for new construction, <br /> M(nimum ten(10)worlcing days after submittal date. Required onsite,Construction Plans;Stormwater Plans w/Silt Fenca installed, <br /> Sanitary Pacil(tles&1 dumps�er;Site Worlc Permit for subdivisionsllarge projects • <br /> COMMERCIAL Attacli(3)complete sets of Building Plans plus a Lifie Safety Page;(1)set of Cnergy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)woricing days after submittal date. Required onsite,Construction Plans,S[ormwater Plans w/Silt Fence(nstalled, <br /> Sanilary Facilities&1 dumpster.Site UVoric Permit for all new projecEs.All commercial requirements must meel compliance <br /> S1GN PERMIT Aftach(2)sets of Engineered Plans.� <br /> ****PFtOPERTY SURVEY roqufred for ali NEW construction. ' <br /> -I-H-1-i-H-H-Fhl-f-f-19-t-hhl-f-I-i-H-1-f-1-1-1-1-I-1-M-H-f-1-H-1-hH-hl-N-1-1-I-I-1-I-H-f-l-1-I-1-H-I-1-1-hFl-H-f-1-I-1-1-l-l-1-1-1-1-1-H-1-H-l-I-1-I-1-I-1-f-hFl-hM-l-1-H-hl-H-i-W-M-H-I-1-1-I-hhl-i-H-hl-1-1-1-i-i-1-H-1-F�-N-i-1-I• <br /> Directions: , . <br /> Fill out application completely. ' <br /> Owner&Conlractor sic�n back of application,notarized ' ' <br /> If over$2500,a Notic�of Commencement is required. (AlC upgrades over�5000) <br /> *" Agent(for the contractor)or Power of A;ttorney(for the owner)would be someone with notarized letter from owner authorizing same • <br /> •OVGR THE COUNTCR pCRMITTING (Front of Application Only) ' <br /> Reroofs Sewers Service.Upgrades A/C 1=ences(1'IoY/Surveyll=ootage) <br /> Driv�ways-Not over Counter if on public roadways.:needs ROW <br />