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nia-ruu-uutu �,i�y ui �ephyrhi�ls Permit Appiication Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin -- <br /> Owner's Name � ` r �C L, s�7V1 Owner Phone Number <br /> Owner's Address 7 � 5 � -� <br /> Owner Phone Number <br /> Fee Simple Titleholder Name � -� Ovmer Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS S �( t � S t 2 P Y Z. • , �S !' ^33s� LOT� �� <br /> SUBDIVI310N PARCEL ID# �����8�Z - dVI� �IU yC0 -�%�O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �u U � C7 ��' fj�,� ��� �r.�j�,� � � y� <br /> BUILDINti SIZE SQ FOOTAt3E HEIGHT �� <br /> QBUILDING S po � V VALUATION OF TOTAL CONSTRUCTION <br /> . <br /> QELECTRICAL s AMP SERVICE Q PROGRESS ENERGY Q W.R.E.0 <br /> QPLUMBING a <br /> 'I' � �7�L <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS � ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES N(� <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y J N FEE CURRE� Y/N <br /> Addreas License# � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r -� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addresa License# � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Llcense# � <br /> OTHER COMPANY ���¢���� v�( � �1'! C <br /> SIGRIATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Address C�C d S I'" Sa Qi�9K t�V h n 3 35 �� License# �(.,C �-�r7�l$- / <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)vwrking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles 8 1 dumpster;Site Work Permit for subdivisio�s/large 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 conshuctlon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliNes 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Atfach(2)sets of Engfneered Plans. <br /> "`•PROPERTY SURVEY requlred for all NEW construcGon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of appitcatlon,notarized <br /> If over i2500,a NoHce of Commencement is required. (AlC upgrades over 57500) <br /> '• Agent(for the contractor)or Power of Attomey(for the owner)would be sameone with nota�ized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurveylFootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />