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, i <br /> , $�a-7�o-ooza City af Z phyrhills Permit Application Fax-813-780-0421 <br /> Buiiding Depariment <br /> Ciate Received ' ('� r� ^� <br /> � `� �� Phane on#act for Permitfin �,1�� t�t11 -�F�� <br /> oeuner's 1�ame al1c� Ac Lt t S-�io � Lcc. <br /> +'�S ��-��-� �-s��) Owner P'hone Cdumber <br /> Obvner's Address � C-�t�„�C�C��' (at�- K��'Y1(14, L ��j(¢a� pyy�er Phone Number �— ��� <br /> Fee Simpte Titleholder Name �—� r i Qwner Phone Number �� ^ �� <br /> ' i <br /> � <br /> Fee Simple"Tittehaider Address <br /> JOB A1C►DRESS �1�� t�� �1• Z S r'4i� ��Sy�. LOT# �� <br /> � <br /> SUBDlVlSIdN � � PARCEL ID# l�" r�0-c�� 'C�C7l l��~�c�.�' U�c�..� <br /> ___—_.�_ ,_..- ' - -- -� ---- ---� - ---- —_ _�_--= -' -- - � _ —___-_ <br /> � � f (OBTAINED FROM PROPERTY 7AX N0710E) <br /> WoRK PROPOSED � r��w coNSTa 8 ADD/ALT [_] SIGN [� [r] DEMOLISH <br /> tNSTALL REPAIRj n <br /> PROPQSED U3E Q SFR Q Gt�;;AN►; y � OTHER <br /> 7YPE OF GONSTRUCTIOI� [� BLOCK Q FRAME� C� STEEL Q <br /> L1�SCRi�T10N OF WORK ��--��(� ,l'�`Q-- � ' `,C�C„('C�'�.,.�� <br /> BtdlLDING SIZE �� � SQ FOOTAG ; � tiE1GHT C�_ � <br /> QBUILDING ($ � V LUATfON OF TOTAL CONSTF2UGT40N <br /> �^ � <br /> [�]ELECTRICAL ($— � A P SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> �...._....,__..._ ; <br /> PLUMBING $ ; <br /> �lC�,� , � `��,t� <br /> QMECHANICAL $ V LUATIONI OF MECHAMCAL INSTAL�ATION <br /> � <br /> �]GAS [� ROOFING Q SPECIALTY � OTHEF2 <br /> FINISHED FLOOR ELEVATIONS FLOOD)ZONE AFtEA QYES NO <br /> BUILDER COMPANY <br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � ; �icense# <br /> ����� <br /> ELECTRIClAN - COMPANY <br /> SIGMATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ' I l.icense# �— ���� <br /> PLUM�ER ' `Jy���3i � �? ig ,,�•�^ , G I MPANY n'�,�5 �1``l�j,(�,�j, t C1C_... <br /> SIGNATURE l.L��[r ��T��J� —' ! � REGISTERED Y N FEE CURRE� Y RI <br /> Address 51(��J ,�"t�h S� ��t�1�5 4 Z. �'j�y c�� �.�cense# ��-�.�����c�a � <br /> M�CHANICAL � COMPANY <br /> SIGIdATURE ! REGISTERED Y/ N FEE CURRE� Y/N <br /> address � I L4cense# �� �:� <br /> I <br /> OTHER ' COMPANY <br /> S(GIdA7'URE REGISTEREQ Y J IV FEE CtTftREA Y/N <br /> i <br /> Address � � License# r— � � <br /> � <br /> a <br /> RE5IDENTIAL Attach(2)Plot Plans;(2)sets of Building PI ns;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submi tai date. Required ansite,GanstrucUon Pians,SEormwa#er Pians wi Siit Fence instatied, <br /> San�tary Faciiltles�1 dumpster,Site Wor4c ermit for subdivisions(large proJects <br /> GOMMERCIAL Aktach(3)complete sets of Build(ng Plans lus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submi tal date. Required onsite,Construction Plans,Stormwater Pians w/Sitt Fence instalied, <br /> Sanitary Facltitles&1 dumpster.Sate WarK Permit far ati new pra}ects.AIE commerc�al requirements must meet campliance <br /> SIGR}PERMlT Attach{2)sets of Engineered Plans. <br /> *""PROPERTY SURVEY required for atl N W cbnstruction. <br /> Directlons: � � <br /> Fiil out application completely. � <br /> Owner&Contraokor sign back of applica#ion,notarized � <br /> If over E2500,a Notice af Cammencement fs reqaired. {A/C upgrades over�7'500) <br /> , 1 <br /> "* Agent(for the contractor)ar Pawer of Attomey{for the o er)would be sameone wlth notarized lerier'frorrm owner authorizing.same , <br /> � ,... .. „ ,.. •.,:.}: <br /> ONER 7HE GC}l3NTER PERMlT('!NG {Fcont.of.�AppBcati n.Qnly);.;,: . , , ., , ' _ , _ , <br /> Reroofs if shingles Sewers `! Service',Upgrades�A/C : ' ;Fences(Plok/Survey/Footage) � , � <br /> �riveways-Not over Countsr if.an pu6lic r6adrvays..need F20W� l i � "- " - -. �,-.- � �•��.. ._.. :__,„_. . <br /> � <br />