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813-780-0020 �t Of Z �i <br /> tY ep yrttips Pertnit Applit�tion fax-Bt3-780-pp21 <br /> , BuUding peparUnent <br /> Datt Received <br /> Phone Contasx for P��n <br /> Owrtser's Name ""� <br /> Ow,ner Phorn Mum6er /���D �/`` ��/Q <br /> o�„ers Addresa �y�Yt�o°h��i6� C'�� _ ` <br /> Fee S3rrepla Titieholder Name Q� ��C� �'�IZ C,�e ��i ,,.,—T-_ �� , //� <br /> — Owner Pfions Number /n��X/� L <br /> UL!� ar� _i (�. <br /> Fee SitnR�e Tideholder Address .Z'� a N s'(�l cc�� �i�►il� 2D /3��,� Crr,� wYd /�4 i 'f o� <br /> ,roe aQa�ess �� /�L L L/ / � <br /> �.or r <br /> suenrnstorr � PARCELl6A v'S 'Z( �--ad 16._Q�4�C7 �QO <br /> WORK PRCtPQSED e ,_.j� iQBTA1NE0 FRO(c1 ppOPERTY FAX N0T1C� <br /> NE+�/CONSTRB AQD/ALT t/C I SiGN O Q DEMOUSH <br /> IRiSTALL REPAIti ��t' <br /> FRQPOSED IJSE Q SFR � CdMM r�—� <br /> 'CYP6 iJf CONSTRUCTIBN [� Q FRAME u �HER <br /> BLbCK C'� �E�� � �_ <br /> -�� <br /> DESCRIPTtQN OF WQRK � V� <br /> r L�N+�LO� l�`�I s�n,�rLe.� Tp �'v1/✓i�. <br /> sun.��N�srzE SQ FOdTAGE ' �y' /'ca S S <br /> HE{GHT �� <br /> �6U1�DING y <br /> VALUATlON OF TpTAL CONSTRUC710N <br /> �LECTRlCAL $ AMP SERVICE � <br /> PRO�RESS EFlERGY Q Y✓.R.�,G <br /> �_y�PLUM9ING y � <br /> T-�- <br /> �MECHANICAL �'"—� VALUATiON OF MECHANICAL INS7Al.t_ATION <br /> �__ <br /> �GAS � ROOF�NG Q SPECiALTY �� OTHER <br /> FtNtStiEO FLOOR ELEVATIONS FLOOp 20NE AREA <br /> QYES P7Q <br /> 8lttLCJER � � 1��'vi�L.-�( �Af�j Y�IJG,I�Ip.J ��,l Q, <br /> SIGNATIFRE MPANY � <br /> REGtSTERED Y/N FEE CURRE� Y J N <br /> Address t D�{ 1�a �-1 i �� �'( s`'y�(p0;� <br /> �i C—"— �_ Licertse# a�s �`'i d� <br /> Z �tecraictati 1� '7 <br /> SIGN/tTURE COMPANY �C �[..G�� /� � <br /> S j �1 e�`,� REG�STERED Y� /�JJ FEE CURRE� Y J N <br /> / <br /> ��� � Address ��- r�� � r�o ��� FL �,�s�# � �i� � a : <br /> r� <br /> PCElMBER COMPAHY U������, � <br /> S[GNATURE REGISfERED • Y 1 N FEE am�n Y!N <br /> Address /�� o�YW S ,4 U� ����' �'L License# CFe d s6 4� � <br /> MECfiAMtCAL �j� .�(/�/��Y` CUMPANY .' T f I�( ��� � <br /> StGNATURE REGISTERED Y/ N PEE GURRE� Y!N <br /> Address v Uf L �a � d��s,q F� <br /> License# �—'—� <br /> ¢��R COMPANY <br /> SIGNANRE REGISiEREQ Y!N fEE CURREn Y/N <br /> Address <br /> Licetise# <br /> RESfDENTtAL Atiadi(2}Pfat Plans;{2)sets af BWldlrx�p�ans;(1}set of Energy Forms;R-D-W Pwmit tor new consEruction. <br /> Minimum len{10)vrorking days after submlttal date. Requlred onsite,ConstniCtion PIOns,Stortnwater Plarts wI 5ilt Fence installed, <br /> 5anitary Fadtities 6 1 dumpst�;Sfte Work Pertnit tor suDd�visiansllarge proJer.ts <br /> GOMMERCtAL Attach(3)complete se(s of BcriFdfng plans pius a Life Safety Page;(t)set af Energy Forms.R-O-W Permft for new consUvcUon. <br /> Mirrimum len(10)working days after s[�xniital date. Required onsfte,ConsGuc[ron Plans,Slormwater Ptarts w1 Sllt Fence installed. <br /> Sanitary Fadlitles b 1 dumpster.Slte Work Permlt tor aG riew projects,Ali commercial reqWrements must meet compliance <br /> S1CN AERMIT Attach(2)sats of Englneered Pians. <br /> ""PR4PERTY SURVEY requlred fpr all NEW consWCdon, <br /> verecuons; <br /> - -- •� . <br /> Pt0 out apptiption completety <br /> Owner 8 Cantractor sign bacfc of applicatian,notarized <br /> ff over 52500,a I+Eotfce nf Cemmencemeet is roQulred. (AIC upgradea arer 57506) <br /> " Rge�t{for the contractor}or Power of Attomey(for the pwre,gr}wou(d bs someone with notarized lettet From owner aufhoHzitu,�samg <br /> OVER THE COUNTER PERMITTtNG {Front of Appllcatlon Only) "— <br /> Rw,�oafs if shingies Sewers Service Upgrades A/C Fences(PbVSurvey/�ootage} <br /> Uriveways-Not over Counter if on pu6lic roadways..nee05 ROW <br />