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813-7'80-0020 City of Zephyrh�lls Permit Application Fax-813-7eaoa2�
<br /> Buildi�g Department
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<br /> Date Recelved Ahone Contact for Permtt#in —
<br /> Owrner's Name (..� Qwner Phone Numbar C� ��/ �
<br /> Owner's Address � � � � �( Owner Phone Number � �
<br /> Fee Simple Tltleholder.Name �� � Owner Phone Number �� �
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<br /> Fee Simple Tltlaholder Addres� �
<br /> JOB ADDRESS ��C�� Y r�l( �7,�„� �„ LOT# C�
<br /> SUBDIViSiON �— � pARCE�1D#
<br /> OBTAINEU FROM PROPERTY TAX N0710E)
<br /> WORK PROP{aSED NEW CONSTR ADD/A�T SIGN� Q Q DEMOLISH
<br /> INSTALL 8 REPAI �
<br /> PROPOSED USE Q SFR Q COMM Q QTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �� BTEEL Q
<br /> DESCRIPTION OF WORK � -�-� � / �%'G y,,,
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<br /> BUILDING SIZE �— � SQ FOOTAGE�� HEIGHT ���
<br /> �$U������ �,....-�� VALUATION OF TOTAI.CON87RUCTION
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<br /> CTRICA� $� ,�r/���_� AN1P SEF2V1�E ��J PROGF2ESS ENERGY Q W.R.E.C.
<br /> V.
<br /> OPLUMSING �� . ` `��
<br /> QMECHARlICAL $ VALUATtON OF MEGNRNICAl.lNSTA��ATICtN +���`1
<br /> Q�+� Q FtOQFlNG Q SPECIALTY � QTHER
<br /> FINISHED FLQOR ELEVATIONS �� FLOOD ZQNE AREA [�YES NO
<br /> BUILDER COIMPANY
<br /> SIGNATURE REGI Y/ N FEE CurtRE� Y/N
<br /> '���$$ � 5 License# �— �
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<br /> ELECTRIGIAN CO �,r^�' � ld�+ 1�y �'
<br /> SIGNA7URE REGISTERED Y N FE�CURRE� Y/N
<br /> Address License# �� �
<br /> Pl.Utu18ER COMPANY
<br /> SIGNATURE REGIStERED Y/ N FEE CURRE� Y/N
<br /> '�d�� I License# � � �
<br /> MEGHANICA! �(�jL{y�p�y
<br /> SIGNATURE REGISTERED Y/ N ��E cuRt't�n Y!N
<br /> ��r��g License# �� �
<br /> O'iHER I
<br /> C MPANY
<br /> SIGNATURE RE�ISTERED Y/ N FEE CURRE� Y/N
<br /> Addre�s � tice�se# r� —1
<br /> t2EStDENTiAl: Attach(2)P!o#Plans;(2)sets of Bultiltng Plans,('1}se�af Eriergy Forms;R-t1-W Permlt for new construction,
<br /> Minimum.ten:(10};working days after,submittal'date. Requlred onsite,Construction Plans,�Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Faciiides&1,dumpster Site'Work Rermit for subdivislonsAarge proJects
<br /> COMMERCIAi. Attach{3)complete sefs of Buildlrig Plans plus a Ufe Safety Page;{1}set of Energy Faans.R-O-W Perm3t t'or new constructian.
<br /> _ _ Minimum ten(10)working days'after submiktal date. Required onsite,Cansfruction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Santtary FaciliGes&1 dumpster.Site Work Pertnit for all new proJects.All cammerclal requlrements must meet campltanca -- -
<br /> SIGN PERMIT Attach{2}sets af Ehglneered�Plans. �
<br /> •"••PROPERTY SURVEY reguired f�r all NEW cons ctlon.
<br /> I?ELBCtIOt18: i ,` ,..
<br /> Fill out applicaUon completely. � . � � , , 1 � �
<br /> Owner&ContracMr sign back of appllcaUon,notadzed: `
<br /> If aver�2500.a Nottce of Commencement Is raquired. {AtC apgradea�pver$7500} ----� -=., : , ._,�° �°�f�. :..-.
<br /> '" Agent(for the contractor)or Power of Attomey(for the owner)would e someone with noka�ized letter from owner authorizing same �, ,
<br /> OVER THE COUNTER PERMITfING`. .:.(Front of Applicatian,On1y);.�� . '. . �- - � � .-_.._. . ,{_; .. . .,....., _ `
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<br /> Reroofs if shingles Sewers �Service Upgrades.A/C.. - Ferices�(Plaf/Survey/Footage) �� - � �...� �. ., . ",' '
<br /> i �, � .•�t.; - ' ,�,, � `� , : _-� _.. , � . ._ �
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<br /> Drtveways•Nat over Caenter if on pubilc roadways:;needs ROW<i,;��,.; � � '. '�'' - � ; , :`�.�. . ,,...,
<br /> t^�,r�...x-ivy...._, s A-.�.x� :.L.r'I.1...,....» , 4, r. ... ... . . . c.a _ x,. :.r._ t 's.f. A
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