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6t3'taU-UULU C:lty o#Zepii yrhiils Permit Applicafran Fax-813-T80-0021 <br /> Building Department <br /> �- a <br /> Date Received phone Contact for Permittin ��3 7�� -- ��./ 3 <br /> Owner's Name � U G j,,a !QG� Owner Phone Mumber �l3`��-����.� <br /> Oarttier's Address ��� � j�� �T ' Owner Phone Number ��_ � <br /> Fee Simpte TitEeholder Name � � � f3wner Phone Number �— � <br /> I <br /> Fee Simpte Ttttehaider Address <br /> 4' t�.� <br /> JOB ADDRESS � � �OT# <br /> SUBOIVISlOM C � PARCfL iD# <br /> -- - --..._ _ -. - -,- --- - --- - - -- - _._- -- _ (OBTAINED FROM PROPER7Y?AX NOTICE)__�.__ — _---- - -._.�--- <br /> i 1l�QR!(PROPQSED e New coNSra 8 AQD/ALT � SIGN Q - - Q � DEMOLISH <br /> INSTA�.L REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER � <br /> TYPE OF GONSTRIJCTIOtd Q BLOCK Q FRAME � S'1'EEL Q <br /> DESCRIPTlON OF WORK c�r �- / �/4�� !`� �+`"�� <br /> � <br /> 8illl.DtNG S!Z£ � � SQ FC?OTA�E C� HEIGtlT ��� <br /> QSUlLDING �� VA�U TtOi�!OF TOTAL GONSTRUCTIt3P! <br /> ELECTRICAL AMP SERVICE PROGf2ESS ENERGY W.R.E.C. <br /> C� � C� O <br /> QPLUMBING - �i � �c��l <br /> ,,,.... � � <br /> [�NI�CHANICAL $���� v[a� VALU ION OF MECHANICAL INSTALLATlON <br /> � � <br /> QC�AS Q ROOFING Q SPECIALTY � OTHEft <br /> FINtSHED FLOOR ELEVATIONS FLlOOD ZONE AREA QYES NQ <br /> SUi�.DER COMPANY <br /> StGRtATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> ,,,.....„ .....,_—„— <br /> Address I �icense# �� � � <br /> ELECTRlC#AN COMPANY <br /> SIGNIATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address I �Icense# �� �� <br /> FLUMBER � � CtlMPANY <br /> SIGNATURE REGISTERED Y/ IV FEE CURRE� Y I N <br /> Address I i.icense# �� � <br /> MECNANICAL � �� COMPANY ��� S �� ��c l�r,��' L' � � <br /> SIGNATURE REG(STERED Y! N FEE CURRE� Y!N <br /> Address I.icense# �����v?� �� � <br /> O7NER COMPAIdY <br /> SIGNATURE REGlSTERED Y 1 N FEE CURRET Y/N <br /> Address ( l.icense# C^ � <br /> i <br /> I <br /> RESlQENTlAL Attach{2)Plot Plans;{2)sets of Building Plans;{1,)set of Er►ergy Forms;R-O-W Permit for new constn2ctian, <br /> ' MinEmum ten{10)wotlting days after submittal da e. Ftequtred onsite,Constructfon Plans,Stormwater Pians wJ Siit Fence fistalled, <br /> Sanitary Facilities 8�1 dumpster,Stte Work Permi�for subdivislons/large proJects <br /> COMMERCtAL Attach(3)comptete sets of Buifding Pians ptus a Life Satety Page;(1j set of Energy Forms.R-O-W Permit tor new construckion. <br /> Minimum ten(10)working days after submittal date. Required onsite,Consttvction Ptans,Stormwater Plans w/Siit Fence instatled, <br /> .Sanita.ry Facili#les&.1 dumpster.Site Work Permi�for all new proJecks.All cammeraial requirements must meet compliance <br /> StGN PERMIT Attach{2)sets af Engineered Ptans. I - <br /> '«**PRt�PERTY SURIJEY required for ai(NEW co�sUvction. <br /> Directians: <br /> Fiil out appiicatlon completeiy. <br /> Owner 8�Contractor sign back of application,.nota►ized <br /> tf over S25Q0;a Motice af Gorrimenaement Is requi�ed. {AtC upgrades over�7500} <br /> " Agent(for the contractor)or Pov+ie�'of�/�ttomey`(fo�=tfie owrier)would be someone with notarized letter from owner authorixing,sa.me,:.r.,��..., <br /> OY�RTHECOUNTERPERMITTEN����� " {FrontofApplfcation�;t}nt�)�� _ . -, -, - - ,,'':�`-',: � <br /> `..;e <br /> Reraafs if shingles Sewers Seivlce Up'grad'es�`A/C �".F'nces(Plot/SurveylFootage} , , , = ` „";;'`�'�; , ��; <br /> . . , ,. ;,,:.�_'�,. , ,._. ._ � - 1; <br /> � Oriveways-1Vot over Coun#er�if on publfc rosdways..needs4ROW ' y --.; :,' .._ .' ...i,�: >..� -.A . �.- .', <br />