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a�a-�ao-oozo City of Zephyrhilis Permit Application Fax-813-780-0021 <br /> Building Departrnent <br /> ' Date Recefved Phone Contaet for Permittin <br /> Owner's Name 0 l7'0� I Owner Phone Number '� '� ' <br /> Owner's Address �S � • Owner Phone Number <br /> Fee Simple TiUeholder Name Owner Phone Number <br /> Fee Simple Titlehotder Address <br /> JOBADDRESS LOT# � <br /> SUBDIVISION PARCEL IDH <br /> (OBTAINED FROM PROPERTYTA%NOTICE) <br /> WORK PROPOSED e NEW CoNSfR� ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK �� FRAME 0 STEEL Q - <br /> DESCRIPTION OF WORK l ? <br /> :� <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> : QBUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE aEGisrea�o Y/ N FeE cuw�n Y/N <br /> Address ' - License# <br /> ELECTRICIAN COMPANY ,S <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 3���Ct�V�L1/4fc(/ I�,� o Z�/jy License# v <br /> , ��"�-� <br /> PLUMBER COMPANY <br /> SIGNATURE r�Gisrer�� Y/ N �Cu�aen Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE r�Gisr�o Y/N �Cur�n Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE r�Gls�r�o Y/ N �e cuwxEn Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIt1111111111111111Illllltllllllltlllllt111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum len(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a L'rfe Safety Page;(1)set of Energy Fortns.R-0-W Pertnit for new consWction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit far all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW consWctlon. <br /> Directions:• <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice oi Commencement is required. (AIC upgrades over S7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner aulhorizing same <br /> OVER THE COUNTER PERMITIING (Front of Applicafion Only) <br /> Reroofs if shingies Sewers Service Upgrades AIC Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter if on public raadways..needs ROW <br />