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a��-�eo-oozo Gity of phyrhills Permit Application Fax-813-780-0021 <br /> BuOding Department <br /> . Date Received ,.'7_ f phone ontact for Pertnittin �Z ��O ��� <br /> Owner's Name \I R (�Li+4�!lm!___— Owner Phone Number t�}'b� ��1� <br /> Ownets d ress L tt. N Owner Phone Number C � <br /> " �� r�ooy C � <br /> Fee Simple Tiqeholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> J08ADDRESS � fJiV � �� � ��1 � I.dT# � <br /> SUSDMSI4N C- � PARCEI iDt� "�J"�'1� 0 0 f�'�+v�✓�✓�� <br /> tasrn�r�o�tota�aoa�rr Ta�c Nrntcf} <br /> WORK PROP05ED e NEW coNSTR� ADD/ALT C] SIGN Q Q DEMOLISH <br /> IIJSTALL REPAIR <br /> PROPOSED USE � SFR � COMM C� Ol'HER <br /> TYPE OF CONS7RUC77QN Q BI.00K Q FRAME � STEEL Q � —, <br /> DESCRIPTION OF WORK ` w^'� � �r <br /> BUi�pI1dG S1ZE S{2 FOOTA E � tiEiGHT � <br /> QBUILDING � I�)Q -�� V UATION OF TOTAL CONSTRUCTION <br /> t`( <br /> QELEGTRICAL $ /n� g P SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> bGJ <br /> QPLGMBING $ ���OO C�1'"'M�� <br /> Q4�+IECHANSGRG $ UATfON OF MECHANICAL INSTALlAT10N � " <br /> QGAS Q ROOFING Q SPECIALTY �� 07HER <br /> �INISNED FLOOR EtEVAT10NS r�� FLOOI7 ZONE AREA QYES NO� <br /> � <br /> BUILDER � PANY (�"^'(i• �"'"'",L��'. ` �`�L����"� � <br /> SIGNATURE REGISTERED �Y/ N F�CURRen Y/N <br /> Address j�.�S�, �� � ti� '���3�tG3 lScense#�=s—�i'f G�l`Y�� <br /> ELECTRi IAN " �pMPAWY �� ri �' t�' <br /> - SIGNA E REGiSTERED Y 1 N FEE GllRREh Y J N <br /> - �, 33� License# �G 13 b C� 13`$.,3� � <br /> Address �" <br /> �j '� �� � l.L G � �r�e <br /> PI,UMBER � �-- 1 I ��CdMPANY UG � ! �-�L <br /> SIGIdATURE ' aE�is�a�o Y/ N F�cua�n Y/N <br /> Address � .5�'] �SU Z(3i �j1 �f/�is t3cense#tl T�i �d^(1 r�i�S � <br /> MECF#ANICAL COMPANY <br /> SIGNATURE REGISTEREO Y t N F�E Ct3RRER Y 1 N <br /> Atldress License#� �� <br /> OTHER COMPANY � <br /> StGNATURE REGIS��D �„_Y/ N F�cua�n [ Y!N <br /> Address License# <br /> IIIIIIIIIIIIIIII � IIIIIIIIIIIIIIIIIIIII11111111111111111111111111111 <br /> RESIDEFiTSAL Attach{2}Piat Pians;{2}sets of Building tans;{1}set of Energy Portns;R-4-W Permit for new constructlon, <br /> Minimum ten(10)working days after sub ittai data. Required onsite,Gonstruction Plans,Stormwater Plans wl SiSt Fence instaSted, <br /> Sanitary Facilities 8 1 dumpster,Site Wo Permit for subdivisions4arge projects <br /> COMMERCIAL Attach{3}complete sets of Buiiding Plan plus a L'rfe Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction. <br /> Minimom ten{10}working days after suta ittai date. Required onsite,Ganstruction Ptans,Stotmwater Plans w!Silt fence instaited, <br /> Sanitary Facilities&1 dumpster Site Wo Pertnit fo�ali new projects.Aii commercia!requirements must meef eompSiance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "`PR4PERl'Y SURVEY required for a4!NEW consinaction. <br /> Directions: <br /> Fill out application completely. <br /> Ovmer&Contrackor s"sgn 6ack af application,notarized <br /> if over$2500,a Notice of Gommencement is requir d. (AtC upgrades over$7500) <br /> "' Agent(for the conVactar)or Power of Attomey(far the wner)would be someone with natarized letter from owner authorizing same <br /> OVER'EFlE COUNTER PERMITTlNG (Front af Appii tion ONy) <br /> Reroofs if shingles Sewers Service Upgrades C Fences(PloUSnrveytFootage} <br /> Driveways-Not over Caunier if on public roadways..ne ds ROW <br />