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a�aaso-aa2o City of Zeph �hilts Permit Application Fax-813-780-0�21
<br /> � B ilding Department ,
<br /> � � �
<br /> Date Received --� '" phane Go at far Permittin --
<br /> Ouvner's Name 1 P G( (� � Owner Phone Number _��''�
<br /> Owner's Address � � s v�P /'�!�� Ouvner F'hone Number � �
<br /> Fee Simple Titiehalder Name Ourner Phone Number �� ��
<br /> Fee Simple Titlehalder Address �
<br /> JOH ADDRESS � � �� !� � tf Ii � LOT# [___V�
<br /> �
<br /> SUBDIViSItJN �^ � PA CEL tD# ' - ���t � –� ��`/ ��t�,./
<br /> (OB7AINED FROM PROPERTY TAX NOTICE)
<br /> NNORK PROP05ED, NEW CONSTR . AD JA�7 � SIGt�! Q Q DEMQl:ISH
<br /> e INSTALL RE AIR
<br /> FROFOSED USE Q SFR Q CO M � OTFfER
<br /> '�YYF'�OF CONSTRUCTIOM Q BLOCK Q F ME � STEEL Q
<br /> DESCRIPTION OF WORK �(/'/� l; L✓ I r (�/'� /�J/�/t� /�� /�/19,n` � Z.J j��
<br /> �
<br /> BUILDIN�SiZE SQ FOOTAG�� HEtGHT ��
<br /> QBUILDING � � VA�UA tON OF Tt3TAL CONSTRUCTIC�t3
<br /> [�El.ECTRIGAL �s ^� AMP S R1tIGE [� PF20GRESS ENERGY [� W.ft.E.C.
<br /> OP�tlMBtl�tG ��--� h',U
<br /> n ��
<br /> �ECHANICA� $ . VALUA ION QF MECfiANlGAL INSTA�tATIQN �l�'
<br /> .
<br /> [�GAS Q ROOFING Q SP,ECiAF.TY C] OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> �-r �-�l1R��I�i@---.---�__r�.– ___, �__�--- .. - --C13M�ANY= -- - —___ - -° _ �___ _ �
<br /> SIGIdATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> - Address ( ` License# �� �
<br /> �4ECTRICIAM COMPANY –
<br /> SIG(dATURE f2EGISTERED Y/ N FEE CURRE� Y/N
<br /> Address - License# � �
<br /> P�Utf11BER Ct?MFANY
<br /> SIGMATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# � �
<br /> MECHANlCAL � �,���%d�?L�. COMPAMI � /J11P��rf�tt!� /�</ZJU l�f?y 1 t`l/ �
<br /> SIC�rNATURE REGISTERED Y/ N FEE CURRE� N
<br /> Address t �t `I�� 1"C, �icense.# t��,,., 'r �_ i��
<br /> p��E� COMPANY
<br /> SIGINATURE FtEGISTERED Y/ N`- F�E cuRREn Y/N
<br /> Acldress � License# � �
<br /> RESIDENTIAL Attach{2}PIat,Plans;{2}sets of Bullding Pfans;( }set of Ertergy Farms;R-O-W Permit for t�ew ct�nstruntion,
<br /> � Minimum ten(10)working days afte�submittai da e. Required onsite,Construction Pians,Stormwater Pians wl Sitt Fence instatted,
<br /> Sanita►y FacllIties&1 dumpster;Site Work Perm t for.subdivisions/large prajects
<br /> COMMERGIAL Attach{3)complete sets of Buiid(ng Plans ptus a�.ife Safe#y Page;(1 j set of Energy Forms.R-O-W Permit far new constructian_
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Siit Fence instalied,
<br /> Sanitaty Facilities�1 dumpster.Site Work Perm�t for all new projecks.All commeroial requirements must meet campliance
<br /> SIGN PERMiT Attach(2}sa#s af Engineered Plans.
<br /> "'"PROPERTY SURVEY required for all NEW construction. -
<br /> Directions:
<br /> Fill out application completely.
<br /> Owner&Gontractar s'sgn back of appiication,notarized
<br /> if over 32500,a Notice of Commencement is reguired. {A! upgrades over�750Q)
<br /> *' Agent{for the co�Vactor)oc Power.of Attomey,(for�he owner). ould be someone with notarized letter from owner authorizing same
<br /> OV�R THE COUNTER PERtNITi'ING (Front ofiApplicatian 4ni ) '
<br /> Reroofs if shingles Sewers; `�;SerVice�Upgrades'•A/C Fenaes(PIoUSurvey/Footage) '� , . � !
<br /> ._._ ._. . ,�: � � {4- . _... � ._ -'° -
<br /> t�...,� - I -...,.. _ __�.
<br /> � Driveways-Not over Counter if orr;public_�aadwa'ys�:needs F20W � - .-� ' , ` -�
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<br /> �S .. .,.r; , :�'i�: =� r � ,:,. . - ��
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