|
813-�eaooza City af Zephyrhilis Permit Application Fax-813-780-0021
<br /> 8uilding Department �
<br /> Dafe Received
<br /> - � Phone-Cantact�for Psimtttln � -
<br /> Qwner"a Name � � �`1l N�'1$ Ownar Pho»e Humber
<br /> Owner's Address ��b�� .V�R .� - �Owner Phane Number '� �
<br /> Fee Slmple Tltleholder Name � � � Owner Pfi6ne Number �! �
<br /> ;,� ,��.
<br /> Fee Slmple Titleholder Addre�s `°
<br /> .
<br /> JOB ADDRESS �� ����� C�O`� � LOT# C�
<br /> SUBdIVISION �- �� n PARCEL ID# `� �'�S �-� ��� �-'�`�n �` �
<br /> • . - (OBTAINED.FROM PROPERTY.TAX NOTICE��
<br /> WORK FROP{3SED *NEW CONSTR ADDlAI.T Q` SIGN� Q [� DEMOI.ISH
<br /> INSTALL 8� . REPAIR
<br /> PROPi3SED=tlSE Q SFR �. C{}MM' [� OTFtEi2=
<br /> TYPE OF CONSTRUCTION " [� BI.00K �' '[� FRAME [� STEEL `Q'
<br /> DESCRIPTION OF WORK � pJ��.C� � � �j"
<br /> �UI�DING SIZE �.�� � S4 FOOTAGE�_�, HE�GHT, �____w_�
<br /> �$u��"���r' � VALUATiON�t7F OTAL CONSI'RUCTION
<br /> �_�
<br /> QE�ECTRICAI: � � AMP SERVICE Q PRt�GRESS ENEf2GY � W.R.E.C.
<br /> QPLUNIBtNfi� $
<br /> � �
<br /> QMECNANICAL � �. VAlt1A'Ft01tit OF MECHANICAL INSTA�LATION
<br /> Q C�$ Q RQQFING Q SPEClAl.TY-C� OTHER.
<br /> FINISHED FLOQR ELEVATIpNS ��� FLOOD ZONE AREA QYES NO
<br /> BUI�DER COMPANY �� �.�i--�'
<br /> SIGNA -- — REGISTERED Y/ N �ee cu�n � Y/N, '
<br /> Address ' L'icense# � �
<br /> EIECi'RtCFAFl: . � COMPANY � _ -
<br /> SIGNATURE '� REGI9TERED Y/ N FEE CURRE� 'Y/N
<br /> Address ' � ' ,� . .. -Llcense#..:f ��
<br /> pLi1MBER _ ; COMP.ANY..• , �-
<br /> SIGNATURE ' ,REGI3.TERED Y/ N FEE CURRE� Y/iV
<br /> Address ` . � Ucense# � �
<br /> MECHANIGA!' - CQMPANY ,
<br /> SIGNATURE � ,. Re��STErte� Y./ N FEE CURREA Y L N
<br /> Addcess� � ' ' i _ License# � �
<br /> OTIfER . . COM1'ANY : `
<br /> SIGNATURE� � ` � ' REG�S7ER� Y7'N:,, FEE.CUR�� Y/N
<br /> . . . ... , �
<br /> ,. . _ � . .
<br /> Address . . �. _�; ,. > .. . _ . :. .
<br /> ,.,�.� . � ,, . . License# �� �
<br /> RESlDENTIAl:', t Attach(2};Pltif;P.,lans;..{2};sets=of:Biiltdlag°Plaiis;(1j'seE-of E�ergprFomis;;'f2=0-W�Permitfornew�oonstiuctl,an, �' '
<br /> .
<br /> .,Mlnimum�ten;(•1,0);working;days,after.subrriittal;date::Requlred.onslte;�Canstructlbn=Plan`s;Stormwater Plans w/Silt Fence tnstalled,
<br /> SaniteryFacilitles.&�.1zdumpske_r,•Site:WorksPermitforsubdivislonsllarge'proJects � ':`� "" . • '
<br /> COMMERCIAI. Attach{3}�cample#s sets of 8u31dtiig Plains plu's a I:ife Safe#y Page;{1)set af Enetgy Fortiis.R-O-W Pertnit for new�constructlan.
<br /> Minfmum ten(10)warictng days�afker submittal date. Requfred onsite,Constructlon Plans,Stormwater Plans w/Silt Fence Installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permtt for all new'projevis:-All eommerclal requirements must meet compltance
<br /> SlGN PERMIT AttacFi{2)sets af Engl�,t'�ered•,Plans.,=.:,,.,=:� �.. � , ,
<br /> '••"PROPERTY SUR1/EY re,quired for ail_NEW canstrucUon.
<br /> �Dlrections: ... . -, .. . . _
<br /> Fill out applicadon completely.
<br /> OVuner&Contractor slgn back of applfcatlon,notarized
<br /> � tf over�00,a Notice of Commencement is required. ,dNC.�upgrai#es over�T500)
<br /> • �x.n,��:..d
<br /> '" qgent(for the contractor.)'ar'Power'�of�Atf6mey{fo�tiie owner)wauld be scmeone with notarized letter from owner authadzing same
<br /> OYER THE COUNTER,RERM11'•itNG-•�"��- •(Front of ApplicaBon�Only}
<br /> Reroofs If shingles Sewers , Service Upgrades NC� .Fences(Plot/Survey/Footage)
<br /> Driveways-Not over Counter tf on public.'roadways..iieeils ROVN � �
<br />
|