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a�3.►aW���� City ofi Zephyfiilis Permit Application Fax-813-780-0021 <br /> Sufiding Department <br /> V <br /> Date Received - Phone Cantact far Permlttin — <br /> Owner's Name M �i� ���Z- Ow»er Phone Number 1..1 J 1 X������ � <br /> Owner's Address �l S Owner Phone Number � � <br /> Fea Simple Titleholder Name � �� Owner Phone Number �� � <br /> i <br />� Fee Simple Titleholder Address <br />', JOB QDDRESS �l�l � S�' �.oT# � <br /> SUBpiVISlON � � PARCE�ID# <br /> (OBTA4NED FROM PROPERTY TAX NO'flCE} <br /> WQRK PROPOSED e NEW CONSTR 8 Af}D/AL7 [�� SIGN [� [� QEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �J STEEI. Q <br /> i DESCRIPTibN OF V110RK <br /> � ` UC ��� <br /> I BUIl.DlMG StZE ��� SQ FOOTAGE 1 t� NEtGHT C {p� <br /> QBUILDING � ����"'�r VAlUATION OF TOTAL CONSTR[1CT10N <br /> v <br /> [�EL.ECTRICAL [$ � � AMP SERVICE Q PROCzRESS ERfEf2GY Q W.R.E.C. <br /> � <br /> QPLUMBING �r--� �C� <br /> bl i <br /> � �MECHANICAL $ VALUATION OF MEGHANICAL INS7ALLATION � � <br /> I <br /> I'I [�GAS [� ROOFING Q SPECIALTY [� OTHER <br /> =1NISHED F1.00R ELEVATIONS FLOOD ZONE AREA QYES NO <br /> 3UILDER GOMPANY CdO'`��'- ���C�-' <br /> i >IGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> i <br /> I Address �icense# �� ��� � <br /> cLECTRICIAN COMPANY <br /> 3�GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> ,�_,__,,.. ,. <br /> I Address License# � � � <br /> 'I � <br /> �LUMBER � GOMPANY <br /> � iIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> � <br /> Acldress license# � � <br /> �ECHANICAL � COMPANY <br /> ctGNATURE REG�STERED Y/ N FEE CURRE� Y/N <br /> Address License# � i� <br /> ►THER COiMPANY <br /> �tGNATURE REGISTERED Y J N FEE CURRE� Y/N <br /> Address Llcense# � � <br /> ;ESIDEI3TIAl Attach(2}Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for�ew constructian, <br /> Mlnimum ten(10)warking days aEter submittal date. Reguired onsi#e,Construction Plans,Stormwater Plans wl SOt Fence installed, <br /> - Sanitary FacillBes&1 dumpster,Site Work Permit for subd{visfans!large proJects <br /> OMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new consiructlon. <br /> Min3mum ten{10)workEng days after submittat dete. Required onsite,Construction Pians,Stormwater Plans w/Silt Fence installed, <br /> Santtary Facllities S 1 du►i�pster.Site Work Permit for ali new projects.Ati commerciat requirements must meet complEance <br /> IGN PERMIT Attach(2)sets of Engineered Plans. <br /> "*'PROPERTY SURVEY required for all NEW construc6on. <br /> lrectlons: <br /> Fi}I out application camptetely. <br /> Qwner&Contractor stgn back af appt�cation,notarized <br /> If over�2500,a Notice of Commencement is required. (A!G upgrades over$750Q) <br /> Agent(far the contractor)or Power af Attomey(for the owner):would be someone with notarized letter from owner autharizing same <br /> VER THE COUNTER PERMITTING (Frant.of Application Only) � <br /> eroafs if shingtes Sewers Service Upgrades AIC, Fences(Plot/Survey/Footage) <br /> DNveways-Not over Counter if on public roadways..needs ROW- ,;:_ ._,_' <br /> i <br />