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a��-raaoo2o City of Zephyrhiils Permit Appiicatian Fax 813-78aooz� <br /> BuElding Qepartment <br /> , �_ -�s. <br /> Date Received phone Contact for Permitting <br /> 0�vner's Name �/�"1a✓7 �l�KG+? w��`r'e�'��i5 �--�-� Owner Phone Number <br /> Owner's Address Owner Phone Number � <br /> Fee Sfmpfe T!tleholder Name ( � Uwner Phane Number � � <br /> Fee Slmpie Titieholder Adtiress <br /> :/ j � <br /> J09 AC?QRESS � �3� ��j/ �r��� LOT# <br /> SUBDIVISION �� � PARCEL ID# <br /> (OBTAIN�p FROM PROPERTY TAX IdOT14E) <br /> WORK PROPOSED e NEw CONSTR 8 ADD/ALT � S1GN Q [� DEMOLISH <br /> INSTALI REPAIR <br /> PROPOSED llSE Q SFR [� COMM � OTHER <br /> TYPE OF C4NSTRUC'[ION [� BI.00K Q FRAME � STEEL Q <br /> DESCRIPTIONOFWORK �^'�S'��� �� �� �ti �� ��'���{ <br /> BUILDING SIZE �—� SQ FQOTAGE C� MEIGHT ��� <br /> QBUiLDING 3. j>�_,._ ^� VALUATION OF TOTAL CONSTRUCTION <br /> 1< .. <br /> QELECTRICAL � � AMP SERVtCE Q PRQGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING �> � ��jy jt � � <br /> � '�, ��� <br /> OMECHANICAI ($ — —� VA�UATEON OF MECHANICAL(NSTACLATION <br /> � `� �� . � <br /> QGAS Q RQQFINCa Q 3pEC1ALn � OTNER `�� <br /> ����� �� <br /> FINISFSEd FIQOR EIEVATtQNS � F�OdD ZCJNE AF2EA QYES t30 � <br /> .�°�"' <br /> BUILDER COMpANY - <br /> SIGNATURE REGISTERED Y I N FEE GURREt� Y 1 FI <br /> Address I.icense# � � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE RectsrE��o Y! N FEE CURREM1 Y!N <br /> Address Llcense# � ^ ! <br /> PLUMBER � COMPANY <br /> S{CyNATURE REGlSTERED Y I N FEE GURRER Y 11V <br /> Address License# � I <br /> MECHAR+IICAI. COMPANY <br /> SIl3NATUFlE REGIS7EREQ Y i N FEE CllRRER Y/N <br /> Address ��� License# � � <br /> OTHER ����'�1` <br /> SIGNA7URE tt���s7�t�Q Y/ IV PEE GURRER Y!PI <br /> Addrass License# � � <br /> RESIDSNTIAL Attach(2)Ptat P1ans;{2}sets of Buitding Plans;{1}set of Energy Farms;R-O-W Permlt for new construction, <br /> Mtnimum ten(10)working days after submittal date. Required onsite,Canstruotion Plans,Stortnwater Plans w/Sflk Fence instalted, <br /> Sanitary FaciUties&1 dumpster;Slte Work Permlt for subdivislonsAarge projects <br /> CC?MMEl2C(AL Attach{3}complete sets of Building Plans ptus a l3fe Safery Fage;(1)sat of Energy Forms.R-O W Permit for new construcUon. - - - <br /> Minimum ten(1�)working days after submlttal dake. Required onsite,ConsWot�an Plans,Stormwater Plans w!Silt Fenae instal4ed, <br /> Sanitary Facilities 8�1 dumpster.8ite Work Permit for all new projects.All commercial requirements must meet comptiance <br /> SiGEI PERMIT Attach(2}sets of Engineered Ptans. <br /> •'""PROPERTY SURVEY required for all NEW cansUucUan. <br /> Dtrections: <br /> Fil!out appllratton campletely. <br /> Owner 8�Contractor sign back of application,notarized <br /> ff over 52500,a Notice of CommencemeM is requlred. (A/C upgrades aver S750d) <br /> " Agent tfor the contractor}or Power nf Attomey(far the owner}would be someone with notarized tetter from owner authorizing same <br /> �VER THE COtiNTER PERMITTING (Front of Appiication Onty) <br /> Reraafs if sh�ngles Sewers Service Upgrades A/C Fences(PfotlBurvey/Footage) <br /> Driveways-Not aver Counter if on pubtic roadways..needs ROW <br />