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+ si�-�saoozo City of Z phyrhilis Permit Application Fax-813-780-0021 <br /> : Building DepaAment <br /> ; ' <br /> i <br /> Date Received <br /> Phone ontact for Permitting <br /> ) m <br /> OwnersName `T�e(n�a liOpF�'�1 I � � — ���— -1 <br /> Owner Phone Number <br /> Owners Address P0��S C�vl/Y� � �10. 1�(h-l'�' �'! Owner Phone Number <br /> Fee Simple Tideholder Name �l0 � Owner Phone Number <br /> I <br /> Fee Simple Titleholder Address I <br /> JOB ADDRESS J l0 r n �7c�1 I e �7'V LOT# � <br /> i <br /> SUBDIVISION PARCEL ID� ��7^'��J ���"����`�Q� y y0 <br /> (OBTAINED FROM PROPERTY TA)C NOTICE) <br /> WORK PROPOSED e NEW cONSfR e ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME i � STEEL Q <br /> DESCRIP710N OF WORK �!� l.�(l ' V � �; 5 1-Ol1 ��i'Pln✓►� <br /> BUIL�ING SIZE SQ FOOTAG � HEIGHT � <br /> r-rr'rrr'e- <br /> �BUILDING $ V UATION OFITOTAL CONSTRUCTION <br /> QELECTRICAL $ A P SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> . QPLUMBING $ O` <br /> �MECHANICAL $ �/� �i? V LUATION OF MECHANICAL INSTALLATION �`�� <br /> � � �Q 0 ��� <br /> QGAS Q ROOFING Q SPECIALTY� � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> � ri .�I��....��..-.-..-...r..-r�...��r-.-.-..-.-..-r�.--r:.i� <br /> BUILDER COMPPNY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> i <br /> Address I License# <br /> I <br /> ELECTRI CIAN COM PANY <br /> SIGNATURE REGISTERED " Y/ N FEE CURRE� Y/N <br /> i <br /> Address I License# <br /> PLUMBER COM IANY r— <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> . i <br /> Address 1 License# <br /> MECHANICAL COM IANY I`I V� 1� \ A � vl�C <br /> SIGNATURE ' REGISTERED N FEE CURRE� Y/N <br /> � <br /> Address /�p ���l�Z v_/ I License# �Si� p� ( �p <br /> I <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> i <br /> Address I License# <br /> Illlltllttlllllllllltlllltlt 11111111111111111111111111111111111111 <br />� RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building PI ns;(1)se[of Energy Fortns;R-0.W Permit for new construction, <br /> Minimum ten(10)urorking days afler submi al date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work ermit for subtlivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans p us a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construIXion. <br /> Minimum ten(10)woriting days after submit al date: Required onsite,ConsUuction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Faalities&1 dumpster.Site Work ermit for all new projects.All commercial requirements must meet compliance <br /> SIGN'PERMIT Attach(2)sets of Engineered Plans. <br /> ««PROPER7Y SURVEY required for all N W construction. <br /> �1-' 1-�5....-r.--r .-.�-.-.�-r6-1�-7..r..-r�..-r.....-r..-r..-..-r.--.-.�-.-r���1-�1-�� <br /> Directions•• <br /> Fill out application completely. ,., _ � <br /> Owner 8 ConVactor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgredes over$7500) <br /> " Agent(for the conVactor)ar Power of Attomey(fordhe o er)would be i omeone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITI'ING (Fronl of Applicatio Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not aver Counter if on public roadways..need ROW � ' <br /> I <br />