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���-��w�� Liry ot�ephymiils Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received � _ _ <br /> Phone Contact for Permittin <br /> Owners Name �G`�R C�C��Y.�e�- <br /> Owner Phone Number � �3 - 3 a� - 3�a�, <br /> Owner'sAddress 3' -ec���w`�d LJ� � (� <br /> 2 � Owner Phone Number � <br /> Fee Simple Titleholder Name � <br /> Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � 3� � fi;v u;c3 c•� �,,� r�� �� LOT* S S <br /> SUBDIVISION PARCEL ID# 3""Z1�-- Z l 'U I�-I U- C�0 OCG- U S S O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> IMORK PROPOSED e NEW CONSTR ADD/ALT �� SIGN [� Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM C� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME C� STEEL Q <br /> DESCRIPTION OF WORK .��,��-� �j 1T�--�j C{-�� �Q v L i C.S� S h+ <br /> BUILDING SIZE �— —1 gp FOOTAGE�� HEIGHT <br /> BUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> _ r�,..- <br /> QELECTRICAL $ AMP SERVICE 0 ROGRESS ENF�GY } W.R.E.C. <br /> �i � <br /> QPLUMBING a �J �� �'" � <br /> %� <br /> MECHANICAL / <br /> 0 a VALUATION OF MECHANICAL I T N� � �� <br /> QGAS �] ROOFING Q SPECIALTY � OTHER � ��' ~. <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N ` <br /> Address License# �— <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REC�ISTERED Y/ N FEE CURRE� Y/N <br /> Add►ess License# � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Piot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucGon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlides 8 1 dumpster,Site Work Permit for subdivisions/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 constructfon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,StoRnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Perm(t for all new projects.All commercfal requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Pians. <br /> ""'PROPERTY SURVEY required for all NEW consVuctton. <br /> Directlons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of applicatlon,notarized <br /> If over 52500,a Notice of Commencement fa requlred. (AJC upgradea over s7500) <br /> •" Agent(for the contractor)or Power of Attomey(for the owner)would be sameone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of AppllcaHon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />