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813-T84-a020 City af Zephyrhiils Permit Applicatron Fax 813-T80-0021 <br /> 4�'-� <br /> 8uildEng Department <br /> Date Received Phone Contact for Permittin �d`'` c���- �� j j <br /> Owner's Name �?' �C� L�! // Ownet Phoae Number <br /> Owner's Address �� �D^��' �" � Owner Phone Number �— � <br /> Fee Simple Titlehalder Name � � Owner Phane Number p� r„�%""����� <br /> Fee Simple Titleholder Address <br /> J08ADDRESS (O�� /�""�i''7f7 . � CYl� e �I�S 1.OT# ��i <br /> SUBpIVISION ��`(/c°-rG ��� PAltCEl.ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PFtOPOSED , e NEW CONS7R 8 ADD/ALT �� SIGN Q Q DEMOl.1SH <br /> INSTAL� REPAIR <br /> PR4POSED USE Q SFR Q GOMM 0 OTHER <br /> TYPE O�COMS'fRUCi'!t}N �.. BLQCK C] FRAME [� S7EE� Q <br /> DE3GRIPTION OF WORK ,/'T G �G t �� G' y/'` i,.�° � tSYy� y 7� l'o�� <br /> BUILDING SI2E ���C..� � SQ FOOTAGE C�'���� HEIGNT ��� <br /> QBllILDiPfG �_-----� VALUATION OF TOTAL CONSTRUCTIQN <br /> QELECTRIGAL �_-�--'� AMP SERV�CE Q PROGRESS ENERGY C] W.R.E.C. <br /> QPLUMBlNG ($ —� ��t � � <br /> L � � <br /> �MECHANiCAt. $���Ot VAIUATION C}F MECHANICAL INSTALLATION - <br /> [�GAS Q i200FlNG Q SPECIALTY [� OTNER <br /> FINtSHED Fk.QOR El.EVATtONS ��� F�OQD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> StGNATRIRE t��iS7�f�� Y/ N FEE CURRE� Y/N <br /> Address Llcense# �— � <br /> E�ECTRICiAN GOM PANY <br /> SIGMATURE REGiSTERED Y/ N FEE CURRE� Y/N <br /> Addres� Ltcense# �� � <br /> P�UMBER � COMPANY <br /> SIGNATURE REGtSTERED Y! N FEE CURREt� Y/N <br /> Address License# �^ �� <br /> MECHANICAL COMPANIf <br /> SIGNATURE � REGlSTERED Y I N FEE cuttt�� Y!N <br /> Addres$ (�G��f /ptv� /`,� �G � ��"� License# ��G"�C���/,/`�G�' I <br /> Q"fHER CBMPANY <br /> SIGNATURE REGlSTERED Y i N FEE GURREt� Y i N <br /> Address License# �y � <br /> RESIQENTIAl. Attach(2)Plot Plans;(2}sets af Buiiding'Rlans;{1}sst of Enargy Forms;R-O-W Parmit far new canstruction, <br /> Minimum ten{10)working days after submittal date. Required onsite,Gonstruoflon Plans,Stormwater Plans wl Silt Fence instalied, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsparge projects <br /> COMMERC1Ai. Attach{3)complete sets of Building Pians plus a life Safety Page;(1}set of Energy Forms.R-O-W Permit for new construcHon. <br /> _ Min[mum_ten{10)warking days after submlttal date. Required onslte,Construotlon Plans,Stottnwater P}ans wt S9tt Fence tnstailed, <br /> Sanitary FaclliUes 8 1�dumpster.Site Wa�ic Permit for all new proJects.All cammercial requlrements must meet compllance <br /> 8lGN FERMlT Attach{2)sets af Engineered Plans. , <br /> '"'"PRQPERTY SURVEY required for al!NEW cansWcUon. <br /> Directians: <br /> Ftll out appt�cation completely. <br /> Owner&Contractar sign back of appl(caUon,notarized <br /> If ovar$2500,a Natice of Commencement is required. (AIC upgrades over 57500) <br /> '* Agent(for the contractor}or Power of Attomey(for the owner)woutd be someone with notarized ietter from owner authoriztng same <br /> DVER THE GOUNTER PERMiT11NG (Front of Appiication Onty) <br /> Reroots if shtngies Sewers Service Upgrades AtC Fences{PtoUSurveylFoatage} <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> � -- <br />