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813-780-0020 City of Zephyrhilis Permit Application Fax 813-780-0021
<br /> ' Building Department
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<br /> Date Received Phone Contact for Permitting -
<br /> Owner's Name � G� ffv !�U��lP �S7 C Owner Phone Number �� 7�� " ��ll
<br /> Owner's Address �C� �P�� �`�"'���' �ve Owner Phone Number
<br /> Fee Simple Tltleholder.Name Owner Phone Plumber
<br /> Fee Simple Titieholder Address
<br /> JOB ADDRESS 3$ 6� � L��S��� ��' LOT# �
<br /> SUBDIVISION PARCEL ID# �Z � Z6 " Z 1 - - ��OO� - /ZO�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e NEW CONSTR� ADD/ALT 0 SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
<br /> DESCRIPTION OF WORK ����(% � S�� � yD��y� �o� �P�Ce'2�� �' ` �� PC v � ��
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT
<br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> �LUMBING $ /' On.00 ^��
<br /> ip u �`��i�-
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> .(,� �GYj1
<br /> QGAS Q ROOFING Q SPECIALTY � OTHER � � -S e_5'�(L
<br /> o ���� ,��I � ����
<br /> FINISHED FLOOR ELEVATI�NS FLOOD ZONE AREA YES NO
<br /> BUILDER � COMPANY (
<br /> SIGNATURE ' REGISTERED Y/ N FEE CURREn Y/N
<br /> Address sl�'e '`" °� / y�e�i` �`S License#
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address Licanse#
<br /> PLUMBER � �� COMPANY
<br /> SIGNATURE i REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address ���S � �'�_ ��e ��� � � License'#
<br /> MECHANICAL COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � License#
<br /> OTHER CORf9PANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> RESIDENTIAL Attach(2)'Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, �
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsAarge projects �
<br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Pians w/Silt Fence installed,
<br /> Sanitary Facilities&1,dumpster.Site Wark Pertnit for all new proJects.All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Enginee�ed Plans.
<br /> ""PROPERTY SURVEY required for all NEW construction. - -
<br /> Directlons: '� ` � � ��
<br /> Fill out application completely. �' , ,'� �� '%„ '
<br /> Owner&Contractor sign back of application,notarized 4� � -� '� ` . ti � '
<br /> ; �
<br /> If over E2500,a Notice of Commencemen,t is re qufred. (AIC'upgrades'over 57500) -�- ---- . ' - `�`'� ' - '
<br /> . ;.�._ � � � •
<br /> " Agent(for the contractor)or Power of Attomey(for the owrier)would tie someone with notarized letter from owner authorizing�same� `f��.,,°.°:•_���:=r_..: ..
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<br /> _ ...�,-,y_a; € '�,..i�.'1='.�- '_,. :i:' ; �.
<br /> DVER THE COUNTER PERMI7TING�--�°'� "(Front of,Application Only):�:�j,�,': k , , , -�, ,,r. .�-�,; 1-, i "fr'.:; '
<br /> ,t Seryice U �ades.,i4/C,; .F.,ences•.PioUSurve /Foota e � `;�� � ,,,,, :, „ ,�=�'� `�,
<br /> Reroofs if shingles Sewers , pg. _ (. . Y 9 ) _ - ,' "
<br /> DNveways-Not over Counter if on public roadways�.�.needs�ROVV"' �u' "" - '" '�,, " �'_�."".. ''-"`� '`."`� .�
<br /> :�c,.�. - ._., ,.,,- _.._. ,..- ..
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