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813-�so-oo2o City af Zephyrhilis Permit Application Fax-813-780-0021
<br /> Bultding Department '
<br /> � � ` .
<br /> Date Recelved ff `2 --� ���j f c� `�Z�
<br /> �7 —� �"Phane Contact:for Pe'mttNn _
<br /> Owner's Nama ���""�'� �° � g Owner Phone Humber
<br /> .,,
<br /> Qwner'�Address - � ' Owner Phone�Number '� �
<br /> Fee Simple Tltleholder Name � � � Owner Phone Number �— �
<br /> `�t� '�--
<br /> Fee Simple Titleholder Address a
<br /> JOB ADDRESS � / 7� r� "a� �`�"' -� � LOT# t�
<br /> SUBDIVISION ' � ��-Q �"4'-- �, ' PARCEL ID# � - ` �
<br /> .. (08TAINED FROM PROPERTYTAX NOTICE)•
<br /> WORK PROPOSED '^NEw coNsrst ADD/AtT �` SiGN� � Q DEMOi�iSH
<br /> s
<br /> e INSTALL _ REPAIR
<br /> PROP03ED USE. Q SFR [,�� GOMNI � OTHER '
<br /> TYPE OF CONSTRUCTION ". Q BLOCK' ` 'Q FRAME [-,,� STEEI. 'Q'
<br /> DESCRIPTION OF WORK �� �� �`'`R�"�'' �^`'�' �Q'�`�` } �
<br /> BUiLDING SiZE C� � SQ FOOTAGE���. . HEIGHT. C_„ .
<br /> ..�. QBUILDING ($—� -�;��_.�--• =..:., . .
<br /> L VALUA710N�OF�'�OTAL CONSTRUC710N
<br /> CTRiCAL• � � AMP SERViCE ^ 'Q' PROGiZESS ERIEi2GY Q W.R.E.C.
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<br /> QPl.UtUIB1A1Ca Cs�
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<br /> QMEGHAhtIGAL $ VALUATIdN OF IVAECiiANIGAl.INSTACLATION
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<br /> o�� . o ROOFIl�fG [� SPEGtAI.TY �. OTFEER, •
<br /> FINISMED FLOOR ELEVATIONS ��� FL.00D ZONE AREA_ QYES NO
<br /> BUitDER COMPANY� '
<br /> SIGNA7URE REGISTEREb Y/ N FeE cuR�n Y/N I
<br /> Address " License#'� ' I
<br /> ELECTRICIAN: ._• ,,,�1r� ���� � ' COMPANY - �� � �I�c�-1,�.�.2- Seti.o��
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
<br /> Addre�s r {�.3 °� �aS�-w � �K p.,x" `t ` y ,C L 3',; GY�. , License.#.: �C. I 3�a��"'`9� � ,
<br /> PLUMSER . , , �GOMPANY
<br /> SIGNATURE '� .REGISTERED � � Y/ N FEE CURRE� Y/N .
<br /> Address � ' LicFanse# � I
<br /> MECHANICAI." ., COMPANIt
<br /> •SIGNATURE � � '� REOISTERED � YI-,N FEE CURRE�. Y/N-
<br /> Address`� � - � . � . � License# ( �
<br /> t}THER • ' _ COMPANY ,.3_: ,
<br /> SIGNATURE '� " 'REGISTERED'� Y/ N . � FEE CURRE� Y/N
<br /> Addres$ , ^ _ � , . ,� • � Ucense# �` ��
<br /> ,.,... , � ., .
<br /> RESIpENT1AL, t;�Attach(2)��P:,lot'Plans;.,(2}sefs=of�Bu3tding'Plans;`(1)'set of Ersergyi•Famis;�`R=0-W Penniffor•new ccnstiucfton,
<br /> Minimum�ten�(1.0)�,working,days;�after_submittal_date::Required.onslte;%CanstiucNan Plan's;Stormwater'Plans w/Stlt Fence installed,
<br /> . Sanitary fiacili�es;&�:1:,dumpste_r,4Site:lNortc.Permtl�forsubdlvfsiacis!largeNpro�eats . `", "
<br /> CflMMERGAt,. Attach{3)�comp{ete sets�of Bdiliiing Ptari`s�ptus a Cffe�8afetyr Page;(1)set of Energy Farms.R-O-W Permit far new construction.
<br /> � M)nfmum ten(10)working days�efter submittal date. Required onsite,Constructian Plans,Stormwater Plans w/511t Fence Installed,
<br /> Senitary Facilttles&1 dumpster.Site Work Permit for aii new,project"s:•Ali commerclal requt�emenis must meet compilance �
<br /> StGN PERMIT Attac#r"(2j sets of Engl�,iee'red,Ptans.:.,<,,.;:;.r.,. :-"-;.. . . _ . . '
<br /> .««.pROPERIY SURVEY�equired for aII,IVEW_canshuction. -
<br /> _ . ,
<br /> Directtons: . . � -
<br /> Fill out applicatlon completely.
<br /> C3wner 8 Contractac sign bac�c of appticatlon,na�ti�d
<br /> If over 52500,.a Notice.af.Commencement is requlred. (AIC upgrades over ST500)
<br /> ;,....�»a�.
<br /> '• Ageni(for the�aintraator}o�'Power of Attoriiey�(fo�tt►e ownei)woutd be someone with notarized letter from owner authadzing same
<br /> DVER THE CQUNTER�:P.ERMIITINGi--•-�--(Front of�Appiication Oniy)�
<br /> Reroafs if shingles Sewers Service Upgrades A7C Fences(PlodSurvey/Foatage)
<br /> driveways-Not over Counter if on public roadways..net�cls ROW
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