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$�3-�$0- o o „+^�y,�`- City af Zephyn�a Application Fax-813-780.0021
<br /> ��� � �,1�5�� Building ;t Prt�G �,.AWS"0(1
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<br /> ata�ecel�ad� - ..-� Phbne�Gontaet for Permittln ��3 `1431 - 9ZS(o
<br /> Owner's Name 1� ,�'l,. �e �..°iy/?" �l ,r ,,5` G�-Owner Phone Number
<br /> Clwner's Address � ���t�ta� �Y.�^cd� �2 /��/1'r+�"T C!�y"% ' t L �
<br /> /=4 3��y''� Owrner Phor�e Number
<br /> Fee Simple Tltiehoider Name V; Owner Phoe�e Number � " �
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<br /> Fee Stmple Titleholder Address
<br /> JOB ADDRESS �/� ��d/�J'�/i,Bl,� ��1�� , I,OT#
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<br /> SUSDFVISION � %�� PARCEL ID# � -,�G..a�j- t�!y�rs -d`pj°v.�^v o?rt
<br /> ' '� (OBTAINEd FROM PROPER7Y TAX NOTICE)
<br /> WORiC PROPGISED NEW CONSTR �"ADDtA�T � SIGN� Q � Q DEMQLiSH
<br /> e INSTAL•L 8 REPAIR
<br /> PR4PC1SEd USE Q SFR Q GQMM� � t?THER
<br /> TYPE OF CONSTRUC710N' Q BLOCK � FRAME� � STEEL Q
<br /> DESCRIPTION�OF WORK �eW b�'1'u- �,'v►,�rbi 6aa�o
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<br /> BUILDING S1ZE �� �,SQ FOOTAGE , ` , NEIGHT �_�
<br /> �$�������' �"' � ,VALUATtON OF TOTA�C01�fS7f2UCTION �j{,l�l'{` � �
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<br /> QELECTRICAI. : $ AMP SEF21t[CE Q� PROGRESS ENERGY Q W.R. .C,
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<br /> OPLUMBlRIG $� � �(.�J� ���-� �'�"""
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<br /> OMECHANtCAE, $ VALUATiQN OF MECNANICAI.INSTALLATlON /� � �,Q,,�Tt3 �"C���
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<br /> QGA3 Q RtJOFiNG Q SPECIA�TY � 'OTHER ��j 1 �
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<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO D'�����V
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<br /> Btf{LDER ., /J COMPANY ��Ilt/� �l1rJ�T/"Ldr��`�•T�C._.
<br /> SIGNATURE '��� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address ` License# � t.���, l�tp 0 � 7 �'f� �
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<br /> E�ECi'RtC1AN- �� �����1�� GOMPA�t�tlt
<br /> SIGNA7URE REGISTERED Y/ N ��e cu�t�� Y/N
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<br /> Address i License#°� �
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<br /> PLUMBER ��� ���5����C'�-��v�/�, J� �GONIPANY�
<br /> SIGNATURE REGI3TERED Y/ N - FEE CURRE� . Y/-N
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<br /> Addrass License# � _- �
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<br /> MECHANICAL c.\�" -P ��.��1 �J� 1/ GOMPI4NY '
<br /> SiGNATURE �C..a�` " "r""���v�.��I,.� - REGIS7ERED „ Y/.N , FEE CURRE� Y/N
<br /> Address � � " ' i License.#� �
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<br /> OTNER � ��J1�/U�y �"�COMP�o Y/ N FEe cuRREn Y/N
<br /> SIGNA7URE . � �
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<br /> Address ' ...r`�`_�'L f 11�3.; t' ��,�,��, �153vr G`1T ; �-'License# �I "'U°�v`4°`��t_.�t..t.) �j���
<br /> RESiDENT1Al.� Attach(2),PIofiPlans;'{2?sets�.of Building;Piai�s;{1).seYof Energy=F6rtns;R-Q-W=Perinl#fcir new canstruction, ' '
<br /> �Minirnum ten:.(10);working days after submittai�date5 Required onsite,:Constructian Plans;StoRnwater Plans w!Stit Fence installed,
<br /> Sanitary Facflities�&�1 dumpster Sfte Worfc,Permit forsubdivisions/large pro)ects, �
<br /> COFAMERClAL Attach{3)camplete"sets�ofBuildirig�Plans pltis'a"�ife�'Safet"p Page;(1}set of Energy Forms.R-O-W Permtt far new construcUan.
<br /> Mlnimum ten(10)woricing days after submlttal date. Required onsite,Constructfon Pians,Stortnwater Plans w!Siit Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.•AJ6commercial requirements must meet campliance
<br /> SlGN PERMI7 Attach{2)sets af Englneered,Plans.: " _ � ` �.i � '
<br /> "'"PROPERIY SURVEY required for all NEW construction. '
<br /> �Irectlans: _ � -
<br /> Fill out application completely: i
<br /> Owner&Contractor sign back of appltcation,notatized I �
<br /> tf ovec�2500,a Notice of Commencement Is requlfed. {A/C upgrades over a7500}
<br /> '* Agent(for the'contractor)'orPower of�Attamey{for the owner)would be sorrieone with notarized letter from owner authorizing same
<br /> 7VER TME COUNTER PERMIT'fING_ ,.{Front of.Application.Only) ;
<br /> 2eroofs if shingles Sewers Service Upgrades AJC Fences(PIoUSurvey/Footage) i
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<br /> Drivewaps-Nat over Caunter if on pubtic roadways:n'e'eds'ROW '
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