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,813-780-0020 City of Zephyrh�lls Permit Application Fax 813-78p-0021
<br /> ' BuAdi�g Department
<br /> Date Recelved phane Contac#f r P�rmttt�n
<br /> Owner's Name �s"�J'L' l't 1`�v1s�/ pwner Phona Numbet �'�3 ���� ��'-�
<br /> Owner's Address S��y !"'�v!�'""'�� /��i��• 4wner Phone Number �^ �
<br /> Fee Slmple Tltlehalder.Name r— � Owner Rhone Number � �
<br /> I
<br /> Fee Simple Titlehalder Address
<br /> �
<br /> JOB ADDRESS � LOT# ��
<br /> SUBDIViS1ON � � PARGE ID# ,%�
<br /> (OBTAINED FRQM PROPBRTY TAX NOTIC@!
<br /> WORK PROPOSED NEw COt�STR ADDIA T � SiGN {� Q DEMOLISH
<br /> INSTALL 8 REPAI
<br /> PRQPQSED USE SfR CONI �
<br /> � O M Q OTNER
<br /> TYPE OF GONSTRUCTION • Q BLOCK Q FRAM � STEEL Q
<br /> DESCR1PT14N OF WORK 3 J �""�' �''��l ��uyr
<br /> BllII.DING StZE �� � SQ FOOTAGE —f°r�"{�' HEIGHT � �
<br /> i
<br /> ���tt�t��'' � /����• "�� VAL.UATiO OF TQTAL CONSTRUCTiON
<br /> QEI.ECTRICA! � � AMP SERVI E � PFtOGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBlNG �>� ���
<br /> QMECNANICAL $ . VA�t1AT10 OF NIECHANICAC tNSTALLATiQN � ��
<br /> QGAS [� RQOFiNG Q SPEGI�l3Y Q OTFSEf2
<br /> FINISHED F4.00R ELEVATIONS �� FLOOC�ZONE AREA QYES NO
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<br /> �u��.o�� c I�M��r -�'�-G�� ��y�s c�
<br /> SIGNATURE REC+ISTEREb Y/ N FEE CURRE� Y/N
<br /> �d�g$ License# I �
<br /> ELECTR1C1At+t CClMPANY
<br /> SIGNATURE RE�ISTERED Y/ N FEE CURRE� Y/N
<br /> ����'$$ Ucense# �� �
<br /> PLUMBER �qMpp�y
<br /> SIGNATURE RE�GISTEREQ Y/ N FEE CURREA Y/N
<br /> Address License# �� �
<br /> lVIECMANICA! COMPANY
<br /> SIGNATURE R��isreREa Y/ N FEE CURRE� Y/N
<br /> ���s$ � license# � �
<br /> O7FlER „f C IUMPA�IY
<br /> SiGNATURE � R�GIS'rERED Y/ N FEE CURRE� Y/N.
<br /> Address License# � �
<br /> RESIQ541TIAL Attach(2�Plot Plans;(2}sets of Bullding`Plans;{i}set af Energy�Forms;R-O-W Permit for new coastruction,
<br /> Minimum.ten(1.0)�working;days aRec,submittal date. Requtred onsite,ConstrucUon Plans;Stormwater'Pians w/Silt Fence installed,
<br /> � Sanitary Facil(Ues.&1,dumpster Slte Work=Permit for;subdivisionsAarge pro)ects
<br /> COMMERClAL Attach{3}c�mplete sets af Salldirig Plans plus a life Safe#y Page;{1}set af Energy Fqrms.R O-W Peimit#or new constnsction.
<br /> Minimum ten(10)working days'after submittal date. �tequired onsite,Gonstruction Plans,Starmwater Plans w/Silt Fence installed,
<br /> Sanitary PaciliUes&1 dumpster.Site Wark Permtt for�all new projects.All commercial requlrements must meet compliance
<br /> StGN PERMIT Attach{2)sets oF Engineered•Pta�s._.
<br /> """"PROPERTY SURVEY required for ail NEW cons cdon.
<br /> Dlreations: , . ,..
<br /> Ffll out application completely. - ` '
<br /> Owner&Contractor sign back of applicaUon,notarizecl, � � ; `, 4
<br /> If over�2500,a Natice of CammencemenE is rsqaired. {AJC up raites ove�57500) � ` -_ {, ,, ,,
<br /> �
<br /> " Agent(for the coritractor)or Power of Attomey(for the owrier)would be someone with notarized letter from.owner authorizing same
<br /> .,, � �. _, _
<br /> DVER THE Ct}EFNI'ER PSRMFTi'ING '� ��(Front of Applicetion;f3nly)� ....., ; '•. - - ,
<br /> Reroofs if shingles Sewers Service;Upgrades,A(G�; ,,�Fences.(Plot/S'urvey/Faotage) '' ` _ . ,., , ' � '
<br /> : , '' - ,.�; ,
<br /> � ;� ,„� - � -..,,. � _ .. :t. .
<br /> Driveways-Nat aver Counter tf on public roadways.:nesds RCiW `•'�' � ; „ 4 ` `
<br /> ... .n, ...,� 4,_. .,w_..�v.,.. _.. :�;mK.,.� .,.,,., ,...� _.�.w., :,.:�,.a..
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