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8�3-780-0020 Gi�Cy o�l'G�pnyrnnis rc;tt►ti�r�NN�������„ • <br /> • � Building Do�artment <br /> � �� _ � � � � �'/3 7�. - s"d� <br /> Date RQCOivad 2 Phono ConiacLior Permitling <br /> - - --- - -- ---rl-ri-t-rrrrri-r <br /> - ----- --- - ---- r- - ---- ---- -rrr►-rri-� - --• --- rrrr I <br /> -riitiy-rrrrrrrrrr---- - /� . . . <br /> Dwner's Name GL/t- �.� � '�/U � Owner Phone Numb�r <br /> Ownor's Acldross - ' Dwner Phone NumUer <br /> 1=ee 5implo Tltleholdor Namo • Owner Phono Nunilier� � <br /> �ee 5imple TiLloholder Address ' <br /> JOI3 ADDRLS5 c? 7��5 V /�-� v , .. • � LOT�� � . <br /> SUI3DlVISION ' . .� PARCGL 1D# /D —°�-6 —�/�ld' /oZ-«0' O.IJo�- <br /> . ' (ODTAINED f-ROM PROPCRTYTAX NOTICL-) <br /> WORIS Pf�OPOSCp ' NEW CONSTR ADD/AL.T � SIGN 0 MOVC Q DCMOLISI-I . <br /> � INSTALL . . � I�EI'AIR <br /> PROPOSL-D 115C' ' • � S�R ' �• COMM 0 . OTl-IER ' <br /> TYPG 01=CONSTRUCTIQN � [3LOCl< �� � 1=RAME � _C] STEEL 0 OTl-IER <br /> ocsct�ir�-rioN or-woaK � �u�i'-.0 'Cdl�°�' G�- �/'Oti- � ���� '� ' �" <br /> 13111LDING SIZC ��x '(�U 5Q FOOTAGC � �Q 1-IEIGI-ff <br /> [�] 13UILDING � � �a� V VALUATION O�TOTAL CONSTRUCTION . , <br /> � <br /> [� ELCCTRICAL � , . AMI'SCRVICE 0 PROGRE55 CNERGY • C] W.R.E.C. <br /> � . � ��.q��' � <br /> [� PLUMI3I.NG �i � <br /> . • PA.SCO PERMIT SERVICE - <br /> 0 MCCI-IANICAL :�; � VqLUATION 01=MECI-IANICAL 1NSTALLATfON {813)788-5314 <br /> . • FAX 1-866�24-789� <br /> 0 �as ' [� r�oor-iN� [� s�caA�.-n� 0 OTI-ICR , <br /> rINISI-IED FLOOR CLEVATIONS � f=LOOD ZONEAREA DYES �NO ' <br /> BLIILDCR �`�� � � � ��' COMPANY � v � • �C " . <br /> sICNATURC ���-�_'� REGISTGRED Y/ N FEE CURRGNT Y!N <br /> Adclross ��� 7 .�� � � � Y� ' . Liconse�1� <br /> CLGCTRICIAN • CQMPANY <br /> SICNATURC RHGISTERE� �Y/ N f-CG CURRtNT Y!N <br /> Addres� � � Lfcense#h <br /> • . . <br /> PLUMI3GR • COMPANY <br /> SIGNATURC t�HGISTERED Y/ N• f-GC CURRENT Y/N <br /> Addross Licenso# � <br /> MCCI-IANICAL ' • ' COMPANY <br /> SIGNATURC • • aeelsT�r��� Y/ N hec cur�eNr Y(N . <br /> Address • • .License�#' � <br /> OTFICR � , COMPANY ' <br /> SIGNA'I'URC RCGISTERED ' Y/ N f-EE CURftGNT Y/N <br /> Address , License�# <br /> RC5[D�NTIAL Attaeh(2)I'lot'Plans;(2)s�[s of Qulldinc�I'lans;(1)seL of Energy 1=orms;R-O-W Permltfor new conslruction, <br /> Minimum ten(10)worl<ing days after submittal dale. Required onstte,Co�struclion l'lans;SiormwaLor Plans w/Sill f-ence installed, <br /> ' Sanitary 1=aeiiitles&1 clumps�er;Sife Wor(c Permitforsubdivisionsllargeµrojects • <br /> GOMMCRCIAL Attach(3)complete sefs of Building Plans plus a Life Safely Pac�o;(1)sel•of�nergy:l=orms.R-Q-W Permlt for now construcUon. <br /> Minimum len(10}worlung days after submittal�ate. Renuir�d onsi[e,Construciion Plans,S[ormwater Plans w!Silt f-'enco insEallod, <br /> Sanilary 1=acilities&1 dumpster.Sito Worl<Permil�for all new projecls.Ali cammercial raquirements must meet compl[ance <br /> SIGN PCRMIT Attach(2)sets of Enc�ine�recl Plans.� . <br /> "`***PROPERTY SURVEY required far all NCW construction. ' • <br /> -1-i-1-I-I-I-1-Fi-I-1-1-I-I-I-1-1-1-1-h1-(-FI-I-Ii-I-1-t-1-h1-1-1-I-1-i-1-I-1-1-1-I-1-f-1-1-1-1-1-FI-1-I-I-1-1-I-I-I-1-1-1-1-1-I-1-1-1-I-1-1-1-I-hl-I-i-1-I-I-1-I-f-(-i-I-h[-1-1-1-I-1-hl-1-I-I-1-1-[-1-1-H-I-1-I-1-1-1-1-1-I-1-I-Hi-I-1-1-1-i-1-1-I-I-1-1-1-i-Id-I-1-1-1-I-1-1-h1-I <br /> DlracLions: , . <br /> Plll out anplicallon com�letely. ' <br /> Owner&Conlractor slc�n bacic of application,notarized ' ' <br /> 11'over�2500,a Nofiice a(Cammencemeni•is requirod. (AIC u�grades over:G5000) <br /> "* Agonl(for the co,ntracLor)or Power of.4Ltornoy(For the owner)would be someone wlth noYarized lett�r from owner authorizing same • <br /> •OVCR TI•lG COUNTCR PGRMITTWG (f=ront of Applicafiion Only) � <br /> RQroofs ' Sew�rs Sorvice.Upgrades A/C f-enc�s(Plai/Swvey/[�ootage) • <br /> Driveways-Not over Counter ii on puUlic roadways.:naeds ROW <br />