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I <br /> $�3-?�o-oo2Q City of Zephyrhi{Is Permit Application Fax-813-780-OQ21 <br /> Bui{ding Department <br /> L � <br /> Date Received 8 f� ��c�- - ���,� <br /> Phone Cantact for Permtttin <br /> Owner's Name r � �1 G � � Owner Pbane Number O 1� ��'�'1�c�.� <br /> Owner's Address /"p tPaCtp G-�/L,l,� Owner Phone Number � � <br /> Fee Simple Tltleholder Name � � Owner Phone Nurt�ber �— � <br /> Fee 3lmple Titleholder Address <br /> JOB AUDRESS �4!-'��I � ��e �ji2, �/�/G�.S ��� LOT# [„i� <br /> suedivisioN �- � pARCEI.ID# �T �� c�� l.�DdD ��� DG�,�G1 <br /> (OSTAlHED FROM PROPE{tTY7AX NQSICE} <br /> WORK PROPOSED , e NEW CONSTR� ADD/ALT �] SIGN Q [� DEMOLISH <br /> INSTALI. REPAlR <br /> PROPOSED USE Q SFR Q C(JMM [�� QTHER <br /> TYPE OF CONSTRUGTION [� BLOCK Q FERAME � STEE�. Q <br /> DESCFtIPTIbN OF WORK �-°/I�,�)Ue gt C' IG�G°�? �T� � I� ,�,, �G� � �»7-lwtJe�V'�5 <br /> BUILDING SIZE �� � SQ FOOTAGE C.�� HEIGHT �� <br /> QBUILDING �� VALUATtON OF TOTAL CONSTRUC710N <br /> [�ELECTRICAL ($ � � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> � <br /> QPLUMBIN{^a ($— � �,ry''} <br /> � �� j . <br /> OMECHANiGAI $ � VALUATiON OF MECHANICAL(NSTALLATION �' <br /> y�O /�, DD <br /> QGAS Q ROflFING [� 5PECIA�'iY �� OTHER <br /> FINISHED FLOOR EI.EVATIONS �'� FLOOD 20NE AREA QY&S NO <br /> BUILDER COMPANY <br /> SIGNATURE REGI57ERED Y! N FEE CURRE� Y/(V <br /> Address Lfcense# � � <br /> ELECTRICIAN �� COMPANY <br /> SIGNATURE REGISTERED Y! N PEE CURREA Y!N <br /> Address License# �� � <br /> PLUMBER COMPANY <br /> SIGNA7URE REGISTERED Y/ N FEE CUF2RE� Y/N <br /> Address License# � � <br /> MECHAN1CAt )o_^ n*, co�rpaNV ,�►�J�i�S�d AitJe C�s`��,� TN'� <br /> SIGNATURE ���� ��"'�'� REGISTERED Y/ N FEE CURREI� Y/N <br /> Address 7T7"� �lP� ,� /GL License# r��G•v�� �f� � <br /> ���� COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � —� <br /> RES1DENi1At. A#tach(2)plaf Plans;(2)sets af 8uilding Plans;(1)sef of Energy Forms;R-O W Permit for new construction, <br /> Minlmum ten(10)worktng days after submittal date. Required onsite,Construckion Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facifities&4 dumpster,Site Work Pecmit for subdivistanstiarge proJects <br /> GOMMERGtAt. Attach(3}camplete sets af 8uildErig Plans pius a Life Safety Page;(1)se#of Energy Forms.R-O-W Permit for new wnstruction. <br /> Mfnimum ten(10)working days after submittal date. Required onsite,ConsUuctlon Plans,Stormwater Plans w/Silt Fence fnstalled, <br /> Sanitary FaciliUes&1 dumpster.Site Work Permft for aEi new projects.AI!cammerclai c�equirements must meet compiiance <br /> SIGN PERMtT Attach{2}sets of Engineered Ptans. <br /> `"""PROPERTY SURVEY required for all NEW canstruction. <br /> Directior�s: <br /> Ffll out applicatlon completely. <br /> Owne�&Gantractar sign back of app{fca�an,notacized . <br /> if over$2500,a Notice of Commencement is required. (AIG upgrades over S750Q) <br /> " Agent(for the co�Vactor)or Power of Attomey(for the owner)would be someone with notarized letter frorrt owner authodzing same� � <br /> OYER THE COUNTER PERMITIING (Front of Application Oniy} . � <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIot/Survey/Faotage) � ' <br /> Driveways-Not aver Counter if an public roadways..needs ROW � � " � ' <br />