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e��-�saoozo City of Zephyrhilis Permit Application Fax 813-780-0021 <br /> � Buitdi�g pepartment <br /> Date Recelved 4 .. .<�;..._2,..,,,.....�-�, ,., •.,._..L ,. {��;'�: � %.� �" ���.` t <br /> x• �:Rhone Cantact for�!ermittin.. '��-.. .��.. <br /> . ., I �•:. . ..., � <br /> � �`�= �,��.�.. lii. \�N '\i�rF 4�:�i. -ryu <br /> Owner's Name ` �.,,','':.L�1nJ o ' ' a' I .Owner'Phorie Nuinber`-�'• <br /> ��1-. �,JG.� . e .. _:! <br /> Gwner's pddre�s ,��„�s, �Y:(��'r.t� `. `�.`�'"� •�.:�;r.Owner�Phone.Number , � <br /> - .., <br /> .` . ,.,f_ : : „ .„_„ _ �:a ? " • ..;^^"` . , <br /> Fee Simple Titleholder Name � '. I + Owner Rhone Number � _�� <br /> , � � � - , � <br /> i ` ; � <br /> , , �' . <br /> Fee Sfmple-Titleholder Address <br /> � I L____� <br /> JOB AdDRESS T :J� �} �J � �� � LOT# <br /> _.. <br /> suso�v�sso�r ��� � �atics�.io# 1��- � -a-I - oc��� � a�2��-o e�Z� <br /> I (OBTAINEQ FROM PROPERTY7AX NOTICE) <br /> WORK PROPCISED NEW CON51R ADCt1ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED U3E Q SFR [� COMM � OTNER <br /> TYPE OF CONSTRUCTION Q BLOGK Q FRAME � STEEL Q <br /> DESCRtP'iiOtd QF WORK /�^"l � <br /> BUILDING 81ZE � � SQ FOOTAGE d I S� < NEIGfiT �`� � <br />� OB�4L�}�G �� VA�UATION OF TO A�CONSTRllCTlC?N �7��---- <br /> �� <br /> QELECTRtGA� �;�� AMP SEFttfICE Q PROGRESS EAlERGY Q W.R.E.C. <br /> L <br /> QPlUMBlNG ($-�� �� <br /> � � <br /> QMECHANICAL $ VALUATION OF MECHANlCAI.tNSTAl.tATiQ{� •��� <br /> ' QGAS Q ROQFING Q SPECIALTY � OTHER <br /> FINISHED FLOQR ELEVAT�ONS ��� FLOQD ZONE�REA QYES NO <br /> ' BUILDER COMPANY <br /> � SIGFIATURE REGISTERED Y/ N FEE CURRED Y/N <br /> i Address Lice�se# �_ � <br /> . <br /> � Et��CTRICfAN Ct}MPANY <br /> �^''���AZ��� REGISTERED Y/ N FEE CURRE� Y/N <br /> AtItIt888 E.ICBTIS@# �� � <br /> PLUMBER COl4APANY <br /> SIGNATURE REG�STERED Y/ N FEE CURRE� Y/N <br /> i Address I.�cense# � � <br /> � <br /> MECHANlCAL COMPANY <br /> SICNATElRE REGiSTERED Y/ N FEE CURRE� Y 1 N <br /> Addrxss �icense# � � <br /> OTHER ° a� COMPANY 1��.��a-� . <br /> SI�NATURE ��-����.__ REGiSTEFtED Y/ N FEE CURRE� Y 1 N. <br /> Addres� �`� Z - �... . {,� I Lfcense# �C-��7"7� Z.._.- � - - - <br /> FiE31DENTIAL Attach(2)Plat Plans;(2)sets of•Building Plans;(1)sati of EnergyFortns;R-O-W Permlt for new construckion, <br /> Mlnlmum•ten(10}warking days aEter.submtttal date. Requlred onsits,Construc�on Plans,Stormwater Plans w/Si1t Fence instalCed, � <br /> Sanitary Facilides&1,dumpster S(te Worfc Rertnit for subdlvislons/large projects <br /> COMMERCIAI. Attach(3)complete sets of Building Plan"s plus a Ufe Safety Page;{1}set af Energy Forms.R O-W Permft ior new constructlon. <br /> Mlnlmum tan{10}woticing days after submlttal date. Reqaired onsi#e,GansUuction Ptans,Stormwater Pians w/Sitt Fencer instailed, <br /> Sanitary FaciliUes&1 dumpster.Site Work Permit for all new pro)ects.All cammercial requlrements must meet compliance <br /> SIGN PEitMIT Attach(2)sets of Enginee�ed Plans.� <br /> '*"PFiOPERTY SURttEY required far att NEW cansVua�on. <br /> Dlrectlons: <br /> Fit!ou#appflcatlon completety. <br /> Owner&Contractor sign back of applica8an,notarixed <br /> If over 52540,a Notice ot Commencement ia raqulred. (AtC apgrade�ov�r$7540} <br /> '" Agent(for the contractor)or Powier of Attomey(for the owmer)wouid be sameone with nota�ized letter from ownar authorizing same <br /> OVER THE COUNTER PERMITfING {Front af Appllcatlon Oniy) <br /> Reroofs if shingles Sewers Seroice Upgrades A/C Fences(PIatJSurveylFaotage) <br /> Drlverovaya-Not over Caunter if on pubifc roadways..needs ROW <br />