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s�saso-oazo � Cit}r of Z�phyrhiNs_Permit Application Fax 813-780-0021 <br /> Building Department <br /> P 0 6 <br /> qate Received �- Phone Contact for Permittin ' - — ' <br /> Owner's Na e ��-����"a d�" �¢��p r'"'`�°�'~`' Owner Phone Number <br /> Owner's Address Owner Phone Number �� <br /> Pee Simple Tltieholdar.Nama �� � Owner Phone Number � � <br /> Fee Simple Tttlehoider Address � ���-��l.�� �� <br /> JOB ADDRESS J�c�� U (� � � � �tt/L 2 t"LOT# �____� <br /> $!!BD#VI310N. � � Pl1RCE��lD# - <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WQRK PROPQSED e NEW CdNSTR 8 � ADDJAIT Q SIGN Q � DEMOLISN <br /> INSTALL REPAIR <br /> PROPOSEQ USE Q 'SFR Q COMN! � OTHEft <br /> TYPE QF CONSTRUC710N Q BLOCK Q FRAME � STEEL Q <br /> DESCRIpT10N OF WORK� �t1 rn �.S'�f�,� �s�C 1oS urLe $1 o c�- ���R-1�.�- <br /> BUILDIN�SIZE` � �; SQ FOOTAGE�_� HEIGHT �� <br /> �BUIl.DlNG � $5) ,��b �� -VAlUAT10EJ'OF TOTAC CONSTt2lJC'TIQN <br /> �z� � <br /> QELEGTRICAI: $ AMP SERVlCE Q PROGRESS ENERGY �Q W.R.E.C. <br /> C <br /> QPLUNlBfNG C � <br /> QMECHANlCAL � � VALUATION OF MECHANICA�IfVSTA�LATION <br /> OGAS Q ROOFING, Q SFECIALTY Q OTHER <br /> FINISHED FLOOR ELEVAT�ONS rW� FLOOD ZONE AREA [�YES NQ <br /> L <br /> �-��E a�.���.. ����y �- . <br /> BUI�DER �� �� COMpANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ticense# �� ��� <br /> E�ECTRICIAN: COMPAl�ttY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/'N <br /> Address License#'�— � <br /> �., _ ,,.. _ <br /> PLUMBER COMP,ANY. <br /> 31GNATURE Re�isTErtE�. Y/ N FEE CURRE��, Y/.N <br /> Address ' � Cicense# �- � - � <br /> MECHANlGAL CQMFANY . ` <br /> $tGNATURE � ' REGISTERED � ..Y/ N . ' ,_ EEE CURRE�; . Y/N� <br /> Address � � � ' � license#.� � . <br /> O7kER • • � � COMPANY <br /> SiGNATl7RE . ' - ` - � ' REGISTERED " Y/ N FEE CURREA Y/N <br /> Address Y . - �'L'icense# �'— ' ' � <br /> RESIDENTtAL . -Attach{2).Plat:Flans;`(2}.,setsrtof:Buifding'.Pfans;'(:f}:set of Energy�FoRns;R-{?-11V=Permtt for new construct�on, " <br /> Minimum ten;(,t0}woricing day.s�aftertsubmittal;dater� Requlred onsite;`Constrilctian Pians;Stormu'vater Ptans w/Sflt Fence instailed, <br /> Sanitary Faciiitles&;9;dumpste[;•Si'te VNorii•Permit foc-subdiylsions/large projects- � <br /> COMMERCIAl. Attach{3}cbmptete sets of'Bu(Idltig Plens plus a l:ife"'Safety Page;`(1}set af Enetgy Porms.R-O-W Perm�t for new construction. <br /> Minimum ten(10}woiicing days after submiktal date. Required onsfte,ConstrucUon Ptans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Faoilities&1 dumpster.Site Work Permit far all new.projects.All=commercial requirements must meet campllance <br /> .----St�N-PERNiET- - Attach{-2)sets of-Engineerecl,Plans.:= ,_. :,. - �. . -.. --- - ,� _� _ . _ ,._. <br /> "'"PROPEF2TY SURVEY required for ali NEW constn�ction. , � <br /> 3lrections= � <br /> Fill out appiication compietely. <br /> Owner&Cantractor sign back of applfcatlon,notat3xed <br /> lf ovar 325d0,a No#Ice af Cammsncement Is requir�d. {NC apgrades ov�r s7500} <br /> '" Agent(for the contractor)or Power af�Attomey(for the owner)wauld be someone with notarized letter from owner authoriztng same <br /> �VER TFtE C013NTE42 PERMtT1'tFtG_, __{Front af.Application..Only). <br /> 2eroofs if shingles Sewers Service Upgrades A/C Fenoes(PIoUSurvey/Footage) '• <br /> Drlveways-Not over Counter if on publlo roadways:needs`ROW' <br />