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e�3asa-aozo City of Zephyrhi(1s Permit Application Fax-813-780-0021 <br /> Building Deparkment <br /> Date Received Phone Contact for Parmitting <br /> Owner's Name J r�. � -e, '2 Qv✓ner Phone Number <br /> Owner's Address lJ � �� �T �'� Owner Phone Number ��� ^ ��`7 —��5�-' <br /> Fee Simple Titleholder Name �Df"� r�f� �T �?,��� � � <br /> Owner Phone Number <br /> .r <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# �____!� <br /> sUBO�vtstoN �` Z e ° � l � PAEtCE�iD# <br /> �, <br /> - " _` - ` (OBTAINED'�ROM PRi?PERTY TAX N0710E) - <br /> WORit PROPOSED e NEW CONSTR 8 ADd1A�T [� S1GN Q Q DEMO�ISN <br /> INSTALL REPAIR <br /> Pt2QPOSER USE Q SFR Q CQMM � OTHER <br /> TYPE OF GONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK l� �r a�— '�o � � �l����;�,v-,� ��''A�r`�" <br /> BU1Ld1E1G SIZE �� � SQ FOOTACaE�___,� HEIGHT C�� <br /> �BUILDING $ G r) VA�UATION OF TOTAL CONSTRUCTlC}N <br /> 5� � C <br /> QELECTRIGAL �> � AMF SERVlCE � PROGRESS ENERGY Q W.Et.E.G. <br /> QPLUIVIBtNG �9i �� <br /> L r �� �l D <br /> QMECHANICA� $ VA�UATtON OF MECNANiCAL lNSTAl.IATION J�� <br /> OGAS Q ROOFING Q SPEGIALTY 0 O7HER <br /> FINISHED FLOOR ELEVATIONS �� � FLOdD ZONE AREA QYES NO <br /> lr�' <br /> BUIl.DEi2 ��}��COMPAPtY p <br /> SIGNATUF2E 4�', REGISTERED Y/ N FEE CURRE� Y/N <br /> Add�ess License# �v M� �cU 2, •, y.- � <br /> ELECTRICIAt+t � COMPANY <br /> SIGNATURE ,,, ,,_.,. ,, REGISTERED Y/ N FEE CURREI� Y/N <br /> Attdress ���—. license# �� � <br /> PI.UMBER COMPAAIY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> ,,.�,......,,._, <br /> Address License# � � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Acfdress License# �` � <br /> DTHER C014]PAtdY - <br /> SiGNATURE REGISTERED Y/ N FEE CURREh Y/N <br /> Address [.icense# �— � <br /> RESIDENTIAL Attach(2}Ptat Pians;{Z)sets of BuElding Pians,{1}set af Energy Forms;R-O-W Permit for new cons#ruction, <br /> Minimum ten(10}working days after submittal date. Required onsi#e,ConsUvction 1'lans,Stormwater Plans w/Silk Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work PeRnit far subdivisionsAarge proJects <br /> COMMERCIAL Attach(3}complete sets of Baliding Plans plus a Life Safety Page;{1)set of Energy Forms.R-Q-W Permit for new constructlon. <br /> Minimum ten(10}working days after submittal date. }2equired onsite,Constructfon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new prajeats.All commercial requirements must meet compliance <br /> 51GN PERMtT Attach(2}sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW conskruction. <br /> 3lrectians: <br /> Fill out application completely. <br /> Owner&Contractor sign back of appllcation,notarized <br /> If over$2540,a filctice of Gommenaement is rcquired. {A!G upgrades over�7500) <br /> '" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizfng same <br /> �VER THE COUNTER PERM[TTING (Frant of Application Only} � ��y - <br /> 2eroofs ff shingles Sewers 5enrice Upgrades A/C Fences(PIoUSuroey/Footage) ., � - <br /> Drivaways-Not over Caunter if on public roadways..needs ROW ' � , �' <br />