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, ' 813-�so-oo�o City of Zephyr ills Permit Application Fax 813-780-OQ21 <br /> r'• . " Bui1 ing Department <br /> � _ • <br /> Date t2ecelveii � ". ., -_._ ....,_.�a .�.>-._ . :- Phane Gantact r Permittin - '�� - — -��� <br /> � � . `n�, n J � = :`.':»,;3,C,:.:�. ..)�...;':�.3.�,,�j�_� 1 � <br /> OwnePs Nacne-� (-�t. 't����� • �OwnerlPhane Number . ,Rt.�� � � <br /> Owner's Acldress z t��`-�G...�„ �-»,►..J:.��`��'r � `1 � � SL�wine`r;Phone`Numtier '��t- � <br /> ,j ,k ` . ; i' ... <br /> . h,J . � �. ., , ('� � <br /> Fee Slmple,�TitleholdeF Name ��3 �Owner�Phone�Numbe�, I <br /> t <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �o� '....7 �U 1 ► !��� � �.� �`�—�' LOT# �� <br /> SUBQIVISION �l,J r l.Y��L` I PARC L ID# 2 � ` I�V �AJ�1� <br /> (OBTAINED FROM PROPERTYTAX'NOTICE) <br /> WORK PROPOSED NEW CONSTR ApD! LT• � SIGN [� [� DEM�I.iSH <br /> � e INSTAI:L 8 REPA R <br /> PROPOSED USE Q SFR [� COM C� 4THEFt <br /> TYPE OF CONSTRUGTION [� BLOCK [^] FRAM � STEEL �] <br /> ° DESCRIPTION OF WORK `'`Lr�W� �R1 N L" <br /> BUILDIMG SIZE �i�.a�✓ � SQ FOOTAGE HEIGHT C � <br /> QBU1LDiNG � ��� �. � VALUATI N OF TOTAC CONSTRUCTION <br /> QEI.ECTRICAL � � AMP SER CE Q PRC3GRESS ENERGY Q 1N.R.E.C. <br /> QRI.UMBING � � ` � <br /> QMECNAlVICAI $ VALUATt N OF MECHANICA�tNSTAtLAT#ON <br /> �`�OJ�'V <br /> QGAS � RQOFING Q SPE IALTY Q t}THER <br /> � <br /> FINISHED FLOOR ELEVATIONS �—� FLO D`ZONE AREA QYES NO <br /> BUiLAER OMPANY <br /> SICiNATURE EGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# i I <br /> ELECTRICIAN �OMPANY <br /> SIGNATURE EGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# �^ � <br /> PLUMBER pMPANY <br /> SI(3NATURE EGISTERED Y/ N FEE CURREA Y/N <br /> �ddress I,icense# � I <br /> MECHANlCAL QMPANIt <br /> SIGNATURE EGISTERED Y/ N FEE CURRE� Y/N <br /> Address� License# � � <br /> OTHER � �cOMPANY � '� �-'�'C't��, ���, <br /> SIGNATURE �tEGISTERED Y/ N FEE CURRE� Y/N <br /> Address t`��it;.,�"A' !�►�" 4icense# �-k-�����{�-7 t � <br /> RESIDENTIAI: �Attach(2}Ptaf Pisns;.(2}set`s.of:Bulicling'"Plaas;{1} e#of Energy-Fonns;R-O-W Perinit far new consbvc�on, <br /> Minimum,ten.(•10)working'days aftec,submittal date. Required onsite,Construction Plansr Stamnwater�Plans w/Silt Pence i�stalled, <br /> Sa�ttary��acilittes&;1,dumpster;Site Wor1c Permit r subdivisto�s/large projects <br /> COMMERGIAL Attach(3}coinplete set�of Suili3ing'Plans plus a Lt Safeiy Page;(1)set of�nergy Fo�rr►s.R•O-W Permit for new construc�on. <br /> Minimum ten(10)working days'after submittal date Required onsite,Constructlon Plans,Starmwater Plans w/Silt Fence installed, <br /> Santtary Facilitles&1 dumpster.Site Wark Permik r all�ew proJects:All commerctal requlrements must meet complfance <br /> StGN PERMiT Attacti"{2)sets of Erigineered Plans. �� � <br /> ""'PROPERTY SURVEY required for all NEW con trucUon. <br /> Directtons: ° <br /> Fill out application completely. <br /> Owner&Contraator stgn bacic af applica�on,natarized <br /> tf over�2500,a Nottce of Cammenaement ts requYred. (AIC u grades over�75d0) <br /> '" Agent(for the contr'actor)o�Power of Attomey(for the owner)wo Id be someone with notarized letter from owner authorizing same <br /> DVER THE COUNT.ER,PERMITTING (Front of Appllcation Oniy) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fe ces(Plot/Survey/Footage) <br /> Drtveway�-NaR over Counter if on pubiic roadways..needs ROW <br />