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<br /> a��-�so-oaao City of Zephyrhilis Permit Applicatian Fax-813-780-0021
<br /> s Buliding Department
<br /> Date Receiveci ptiane Cantacf far Permitfing } � /�� -- ���`�
<br /> a,nmer�s tlame . � �R b Owner Phone Number U��� t� I� f �
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<br /> 4wi�e�'s:Address`.�, , � � 1_C�,..+�el �O�i ve Z��i��s 3� ��wner Phane Number �
<br /> Fee Simple Titlehalder Name Owner Phone Number
<br /> Fee Simple TitlehoiderAddress •
<br /> JOB�ADDRESS'•. Q�� IJ�� �• _ I 1 �r�l��� �1 ���..J�� LOT# [___��
<br /> su�n�visiaN ,PARCE�:.ID# I ���"�I - `C�)b "C�o��{�� V �C?�7 C3
<br /> � �(OBTAINED FRQM PROPERTY TAX NOTICE)
<br /> WOi31K t'Rt2POSEp' e N�W CONSTR e ADQ/Al.fi � StGN Q MOVE [� DEMOLtSFi
<br /> � ' INSTAU, REPAIR � ,
<br /> PROFOSED USE , � SFR Q CQMM Q OTHER — (}t} '
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL ' Q OTHER
<br /> DESCRIPTION OF.GWpORK� �C.(.l.'�Ot'f" ��''r� l C..1 ,.� �r�� V�11�I ��r�1�,.4 �fs �i� � ll �„� � ���o�7� �
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<br /> BUII.DING SIZE �— . �:- -.SQFUO.TAGE / �� HEIGHT
<br /> 0 BUILDlN�, $�'=�� /,.�'�S)C; � ��� ,.VALUATION"OF TOTAL.CONSTRUCTtON ' �
<br /> . `�''�' ����7.����♦�.'�'� .. ,.
<br /> � E�.ECi'RICAL �$'—� � AMP SERVtCE Q PROGF2ES8 ENERGY Q W.R.E.G,
<br /> �
<br /> Q � f'�UMBING � � , ,
<br /> .�% '12�"�
<br /> Q, MECHANICAL $ VAGUATION 4F MECHANICAL tNSTALEATION �
<br /> �.— �-1 � 2 U� ? �"
<br /> [� GAS � RQOFII�IG � SPECEAl.TY Q OTHER
<br /> FlNISHED FL.00R ELEVATIONS � � FLOOD ZONE AREA QYES QNQ
<br /> BUI[,DER ' COMPAAIY
<br /> SIGNATURE REGISTERED Y/ N FEE GURRENT Y/(V
<br /> Address License# �. �
<br /> ELECTRICIAN , COMPANY � �
<br /> SIGNATURE REGISTERED Y/ N FEE CURREtJT Y/N
<br /> Address ` ' Liaense# � �
<br /> PLUMBEi2 . j COMPANY
<br /> $IGrIVATURE ' REGISTEREp Y/ N FEE CURRENT Y/N
<br /> I
<br /> Address Liaense# � - �
<br /> MECHANICAL CCIMPANY
<br /> SIGNATURE REC`.,ISTERED Y/ N FEE GURRENT Y/N
<br /> Address ' License# � �
<br /> O�FIER�'#,- .,,, /� /��� J Ct3MPAT�Y ��� �f}C.•' �
<br /> SIGNATURE�� (.� �W�; �� 1���� � �� REGISTER�p Y N FEE CURR NT Y/N
<br /> �i�aa�ess � �� ��'� 1 ii�'-5 ��JS� �`Lficense# �-/�-Z:�-�C;.��
<br /> RESIDENTIAL Attach.{2)Plot Plans;{2}sets of Bu3lding t'lans;{9)set of Energy Farms;32-O-W Permi#for new constructlan,
<br /> , ;-Minimum ten(10)working days after submittal date. Required onsite,Constri�ctibn Plans,Stormwater Plans w/Silt Fence iristalled,
<br /> Sanitaty FaciliUes 8�1 dumps#er,Site YUork Permik#br subdivisions/large proJects , .
<br />` COMMERCIAL Aitach(3)sets of�Buitding Pians;(1}set of Etie�gy Forrns,i2-O W Permit far new canstrucfson: � - � .
<br /> I Minimum ten(10)working ilays after submittal date. Required onsite,Cons#ruction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sani k a t y Fac i l ft i e s&1 d u m p s t e r.S l t e W o r k P e r m i t f a r a l l n e w p r o]e c k s.A I!c o m m e r c t a l r e q u i r e m e n t s m u s t i n e e t c a m p N a n c e �
<br /> SiGN PERMIT � Atfach(2}sets of Engineered Pians. " , '
<br /> •`*`PROPERTY SURVEY required for all NEW construction. . , '
<br /> �ir�ctions: ' ' �
<br /> Fill out�pplication completely. � '
<br /> Owner&Gontractor sign taack of appiEcation,nota�tzed
<br /> tf over�2500,a Notfce'of Commencement Is required. (.QIC upgrades over$5000}
<br /> *" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> �OVER THE COUNTER PERMiTTlNG (Ftont of Appiication Onty}
<br /> Reroofs Sewers � Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Dnveways,-Not over CouPter;if on pubtic'�adways..needs ROW '' �� ,, ;���: "" ,�;- ` � '�� -- ��
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