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� <br /> o�o-�ov-w<v C:ity of ZephyrhiNs Permit Appiication Fax-813-780-0021 <br /> . <br /> Bui(ding department <br /> Date Received �-,,�+��S Phone Gontaet for Permittin �J a-� — ��`"�� � <br /> f3wner's Name v'�� jt�'S ��'�5 Owner Phone Number ,i �� �°��7 J��3j ' ` <br /> i � /� �'� er <br /> Ownar's Address .���1� �i���t•,�i�e�-!1<" � � da. O+n►ner Phone Numb , <br />, Fee Simpte Titlehotder Name " Owner Phone Number �— � <br /> i <br /> � Fee Simple Titieholder Address <br /> J4B ADDRESS �7 l ��� V�• LOT# l�/ <br /> sueoiv�sion� �i � PARCEI.!D# l� ��-.�-(7�/Z�-0� 4L� - d��Y�? <br /> (Q87AINER FROM PROPERTY TAX NQTlGE) <br /> WORK PROPOSED e NEW CONSTR� ADDlALT �� � 81GN Q � Q -DEMOLtSH , <br /> INSTALL REPAIR <br /> PROPdSED USE Q SFR Q COl4tM [� C?THER <br /> 'iYPE QF CONSTRUC?iON Q BLOCK [� FRAME [� STEEL Q <br /> QESCRIPTION OF SMbRK lCOd�� ldt��i� 5��r.•� IcS L✓�Y'"vji �t lJ�rr LA L �,�'/��t-� <br /> BUI�DiNG SI2E �� � SQ FQ07AGE�,.� HEIGHT ���� <br /> QBt11LDtNG $�� �� VALUATION OF TOTAL CONSTFtUCTION <br /> QE�EGTRICAL �—� AMP SERVICE Q PROGFtE5S ENERGY Q W.R.E.C. <br /> �I QPLUNIBING }$ — � � <br /> �� �� <br /> QMECHANICAL $ VALUA7IQN OF MEGhANICAL ENS7ALIATION �/ �- <br /> �� � <br /> � QGAS ROOFING Q SPECIALTY Q OTHER ����� <br /> I FINtSHED FLOOR ELEVATtONS � FLOOD ZONE AREA QYES NO <br /> ( <br /> BUII.QER COMPANY <br /> SIGNATURE REGISTERED Y 1 N FEE CURRE� Y/N <br /> Address License# � �� ^� <br /> EI.ECTRICIAH COMi+AF1Y <br /> SlGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> ,...�,_.�. . <br /> Address License# � .- � � <br /> PI.UMBER COMPANY <br /> SIC�NATURE REGISTERED Y I N FEE CURRE� Y I N <br /> Address License# �— � <br /> MECHANICAL , CONlPANY <br /> SIGNA7URE RE�tSTEREQ Y t N FEE CURRE� Y I N <br /> Addr�ss �� License# �� ' ! <br /> i —�-� <br /> OtHER �' O PANY l<< ��"�'L141�-t , o �.e �G. <br /> SIGNATURE ' REGlSTERED Y/ N' FEE CURREt� Y J M1! <br /> Address 7��� �d1D�� �.. f i S 335�f �tcense# �ce.-C�f��ZL� '� <br /> RESiDENTiAL Attach(2)P�ot Plans(2)sets of Building Plans;{1)set of Energy Fortns;R-O-W Permit for neuv conshuction, <br /> Minimum ten(10)working days after submittal date. Requlred onsite.Construckion Plans,Stomawater Plans wt SPtt Fence InstaHed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivistonsAarge projects <br /> _COMMERCIAL Attach(3�complete sets of Bullding Plans plus-a!.(fe Safety Page;(5}set af.Energy Farrns.Ft-O-WPermit fo�new�canstiuction.� ^ �� <br /> � Minimum ten(10)working days atter submttta!date. Requ3red onslte,Gonst�uctlon Pians,Stormwater Pians wi Siit Fence instalted, <br /> Sanftary Facilities&1 dumpsker.Site Work Permit for all new gro}ects.Al!cammerciat req�irements must meet compitance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '""PROPERTY SURVEY requtred for a!I NEW conshvetion. <br /> Direations: <br /> FAI out epplicatian completely. <br /> Owner&Contractor sign back of appllcation,notarized <br /> If over$28Q0,a Notice oE Cor»mencement fs requFred. (AIC upgradss ovar ST5d0} <br /> '• Agenf(for the con#raotor}or Power of Attomey(for the owner)would be someone with notarized lafter fram owner auihorizing same <br /> DVER THE COUMTER PERMfTTIN�a (Front af AppiEcation Oniy} <br /> Reroofs[f shingles Sewera Service tlpgrades AtC Fences(PIotJSurveyJFaotage} <br /> Qriveways-Not aver Caunter if an pnbiic roadways..needs ROW <br />