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813-780-0020 Cify o#Ze hyr�'tlis Permit Application Fax-813-780-q021 <br /> Building Department <br /> Date Received - , �� Phone C ntact for Permitting � O / ��- --��!�- <br /> OwnePs Name � � h r �Omr7�7d�5 ✓�• Owner Phone Number <br /> Owner's Address j�b"o� �� y u/"/,i�l J� ���C h /n� � Ownner Phane Number �i � <br /> Pee Slmpte Tittehotder Name Owner Phone Number �` � <br /> Fee Simpte Titleholder Address <br /> ,�o�Aoo�xESS �g�� �i�-1� fU . � h rI�11 s� �, ���"�}/ ior# �..� <br /> SUBDiVIS10N � � PARCE�.1D# �� �� c�1 �t �� ���Cr' �V,��' <br /> (06TAINED FROM PROPERTY TAX NOTICEr <br /> WoRK PROPOSED e NEW CONSTR� AQQIALT C� StGN 0 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q S�R Q COMM �� OTHEt2 <br /> TYPE OF CONBTRUC"TION Q BLOCK Q FRAME � STEEL � <br /> DESCRIPT18id t)F WORK ��`� ��� f„� i� + t?'!�5 ,i�J� `� f �.' l.� .��✓!1f� ��! r � <br /> BUILDtNG 51ZE � � SGt FOQTAG C� HE(GHT �.....`� <br /> QBUILDltVG r& ^'� VA UATION OF TOTAL CONSTRUCTfON <br /> L <br /> QELECTRICA� � � AM SERVICE 0 Pf2QGRESS ENERGY Q W.R.E.C. <br /> [�PLUMSING � `�jd �,f.?� �t j�j� SC''� ,.- �� �� <br /> _.......—. .._i r�� <br /> [�MECHANlCAL $ . VA UATIQN OF tNECHANlCAL INS7ALLATlON <br /> �GAS Q ROOFING Q SPECtALTY �� OTHER <br /> FINISHED FLOOF2 ELEVATIONS � FLOOD ZONE AREA [�]YE5 NO <br /> BUfLDER COMPAt+3Y <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> ��-���'��G��d COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— � <br /> P�UMBEFt GOMPANY <br /> SIGNATUI2E REGISTERED Y/ N _ FEE CURf2E� Y/N <br /> Addrass License# �— � <br /> MECHANtCAL CQMPANY <br /> StGNATtlRE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address license# �- � <br /> OTHER ���,� a COMPANY /�5 �P��� C���,�C <br /> SIGNA7UitE REGISTERED Y I IV FEE CURRE� Y/N <br /> Address ��s# ��'��aj i� <br /> RE5IDENTIAL Attach{2)ptot Plans;(2)sets of Bufiding P!a s;(1)set of Energy Forms;R-Q-W Perrrtit for new construction, <br /> Minimum ten(10}work3ng days after submitt 1 date. Required ansite,Construction Pians,Stormwater Ptans w/Silt Fence instailed, <br /> Sanitary Faciflties&1 dumpster,Site Work Permit for subdivisionsAarge projects <br /> COMMERCIAL Attach{3}comptete sets of Building Plans pt!s a Life Safety Page;{1)set of Energy Forms.R-O-VY Permit for new constnsction. <br /> Minimum ten(10}warking days after submittat date. Requlred onsite,Construction Plans,Stormwater Plans w/Siit Fence instaUed, <br /> Sanitary Facilities&1 dumpster.Site Work ermit for all new projeats.All commero(al requirements must meet compliance <br /> SIGN PERMJT Attacfs{2}sets of Engineered Pfans. <br /> "**PROPERTY SURVEY required for all NE construction. <br /> � Directions: <br /> Fill aut appiication completety. <br /> Owner 8 Contractor sign back of application,notarized <br /> If aver 52500,a Notice af Commencement is required. (AtC upgrades aver�T500) <br /> '" Agent(for the contractor)or Power of Attomey(for the own r)would be someone wlth notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTtNG (Front of Appllcatio Qnty) �� <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plat/Survey/Footage} <br /> Driveways-Nat aver Counfer if on pubtEC roadways..needs OW <br />