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"' '-- ---� e..ity vl GCF1flyffllll5 F'@fR1Ii HPPIICBTIOr1 Fax-813-780-0021 <br /> Building Department <br /> Date Received .�—��- Phone Contact for Permittin __ <br /> Owner's Name CO � Owner Phone Number l,3 'Zg 3'Q lo�o f <br /> Owner's Address 50 j'j / �� Owner Phone Number <br /> Fee Simple Titleholder Name D�(Xd ��� �ka� p�er Phone Number � � <br /> Fee Simple Titleholder Addresa U �C� ��4 �!� L 3G �3 <br /> JOB ADDRESS Sd.�I S I I � I LOT# JS <br /> SUBDII/ISION tti �� PARCEL ID� I Z�2 Ce-21 -a 1 c9tl •oQtic7•d!SQ <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> lIVORK PROPOSED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL e REPAIR <br /> PROPOSED USE Q SFR Q COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q S7EEL <br /> pESCRIPTION OF WORK G .,� � w�' � �� � <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> [�BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> .S'C�.c�cl <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS E Q W.R.E.C. <br /> QPLUMBING $ � <br /> ��� a _ <br /> QMECHANICAL a VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGMATURE 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 REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Lfcense# <br /> MECHANICAL COMPANY <br /> SIGMATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY - <br /> SIG(MATURE REGISTERED Y/ N E URRE� Y/N <br /> Address License# r— —� <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlides 8 1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMIMERCIAL Attach(3)complete sets of Buflding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FadOties 8 1 dumpster.Site Work Permlt for all new projects.All commercial requirements must meet compiiance <br /> SIGM PERMIT Attach(2)sets of Engineered Plans. <br /> ""•PROPERTY SURVEY requfred for all NEW consUuctlon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of applicaUon,notarized <br /> If over t2500,a Notice of Commencement is requlred. (A/C upgrades over E7500) <br /> "" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />