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<br /> a�s.�eaooao City of Zephychills Permit Application Fax 813-780-p021
<br /> � ; • Building Department
<br /> � Date Received - - -
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<br /> - _: .,..;. . .:Rhone C r
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<br /> - .;- o"intaat`for.Per'mtftin - `�F. .�..._- .._ . _:.,�. .n, ,�_ .
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<br /> Owner'�Name_. _ F�k�i't iC� _ , '.-.f.� , ` �",OuTrriet PJions Number�' �_- .___.„ .
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<br /> Own��'s Address' . ._ - _ , _ . . ., : _ .... . _ � . . .. ;r°` �
<br /> OwnerPhone Num6er,��'.�
<br /> Fee Slmple Tltleholder Name �� i � Owner Phan�.Number � _��
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<br /> Fee Slmple T(tl�tiolder�Addrea� • - .- ,:. ,_t,.. �.. ._..___.,... .
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<br /> JOB ADDRESS j �-- - - .� ,. ... :.._ . _ . .. . _ LOT#
<br /> ,-SUBDIVIS . �� , � � . .,' -, � ` ,.. ,::,;,- �,':
<br /> ION �� Y PARCEL•ID# '
<br /> • .. , . .- -°"., ;�' , -,, _,_e;_ (08TRINEQ FROM PRORER=Y TA?CNOflCE}, _ ..,. . .
<br /> WBRK:PROPOSED ,- , �NEW:CONSTR � •."-ADD/ACT ?[��' 'SIGN'�'".� , '}f l f . °�,{¢ ry ` "`DEMOI,I§H -
<br /> A � INS?AL•L �. •REPAIR �iY`Y~.{+ _�R_
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<br /> PROP4SER•USE , . � °,.SFR � .`CfJMM'' C„��', ,OTHEFZ • +" _ -
<br /> TYPE'QF CdN3TRUCTION'' _' Q« 'BLOCK ' 'Q'j', �PRAME . ;�,. STEEI.-,� �[,�,� : �. _
<br /> DE3CFtiPTIdP1OFWORK `��IOI�C� Y'��(:U��)flN (.Z.�`.� ,o�_I .i/"'�,� ,�jy`'i::. `- ...ra.,..'. '""-:i.,:�.. , .,; .
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<br /> BUILDING�SIZE: �� ....� SQ:FOOTAGE:�,���, ,. . r.HE1GHT t� . �
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<br /> .. . �BUILDING ' $: '�� . ' _ �,;.�.��`^:-:x. '-.� ,;. " ,. -�.;.:.-;,. •-.�:t - . , < r
<br /> � �VALUi4TION'�IF'TOTAL`CONS7Rl�GTION�°
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<br /> QELECTRICAL . $ AMP`SERVICE " , .,Q, PRQGRESS ENERGY [� W.R,E.C.
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<br /> QPLUM8ING , � ` � -.
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<br /> QMECHANICRI $ �VALi3AT10N OF MECliANiCAI.iNSTAtLAT10Al. �
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<br /> �c�s . =.0, . �oaFr�v�.:;p: s�Ec�a�.�r�r 0- � a-r�eR
<br /> FINISHED FLOOR ECEVATIOIVS ',�� F1.00D ZONE AREA �.�YES.. NO
<br /> BUILD�R I
<br /> �-����,� COMPANY
<br /> SIGNA7URE REGIS'rE�o Y/ N FEE CURRE�' ,, :,YJ N,;.:.- : .
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<br /> Addres� ' ' � Llcense# I �
<br /> ELEG7RICiAN , . �COMPi4NY ' 4
<br /> SIGNATURE � "` REGI$TERED Y/ N FEE CURRE� Y/:N >._
<br /> Address _ � _ . • �.License:#. ` - '` ,.`.� _ , .;;� 'i
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<br /> PLUMBER � COMPANY° .;. ., ." . .,
<br /> ' SIGNA'TURE � ;, ,REGIS?ERED - a��..Y/:nN�^ ` • FEE CURREA- Y/'N: :
<br /> Adflf�88 ,, , LIC61168#�� �N" �:
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<br /> MECHANiGAi: " v-,COMPANIF��
<br /> SIGNATURE , ' � � `� .:ReoI57eReD t �Y�/.,N; :..: ..��E cURREn •'Y 7�id�=� = ' �
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<br /> Address�• • � • ' .` `° � , Cicense:#'.I , � �
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<br /> QTHER � � _ ` , , - .COMPANi� -, =^ .
<br /> SIGNATURE- ` .REGISYEREo ;YI:N<; F,EECURF3EA; : Y�%�I::°` _
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<br /> /WdfABl9 • '},��+'}:' _- ..=�; . .. . ... .l:ICB'1158# � .. . , �'
<br /> .. :.:n.:: - _ ...Jr :,xixi: ..n�.i,nt.Cc�:'.lys' w�k.e��,; - 1;t�;�°""*t�;'!d'' .�:,-. ...4_;� .��u.y;�.,-,'.?._- � ,.. _- . ' , . .
<br /> �u . 2 .. m;ss,:=.
<br /> RESIDENi'IAL:.t:=��f�Attacti;:(2)TPIotl�ialns:�2)'sets.`of��alt�ng'Ptans;,.(1):setof�Energy�Foimis;`�-O-W°i?�rm�,it.for.new;�nsbruct�cn, _
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<br /> -:�.Minimumt,teri%,(�ta);wqiiting.�days�after�.'s"ubririidal�data:=Requl�onsite;C�oiist'r`iicdori�Plans;;�SformwateP Ptans w/,:SfIE:Fenca installed,
<br /> _.,...._.:�sa�ii� �;�a�aii�es�&;��i.� ste�:�s�ce�wo` ;��m;�t: . , �:,�.:�:�:�_�:j: - , : , , :..: _. . . .
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<br /> � �a;,.,,,.;; .,.��:��!�.-r, ��:--�:,,��.a::........a�tor;s�itidiv��lotis�arg��piojecGs'`'. ,_ f^...�^ },�: -
<br /> COMMERC1Ai. Attach.(3)`:compiete:sefspof Bi�ltiiing Ptans;ptus�a„.kife Safety Page;`(1j set of:EnergyEorms:-R-O-W Permit�fo�new�consbuction:
<br /> Min(mum ten(f0)woFiiing days�after submlttat date. Requlred onsite,CrmstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Santtary FadltBes&,tdumpster._Site.Work PermE�for ali'new'proj�cfs:�Ait cammercla!-requtt+ements;must.meet��mpllance
<br /> SFGN•PERMIT Attaich(2�efsof"Engltjeer;eii�Plans;;�:�:�:�w�`�..._- �. . - . .. � �
<br /> """PROPERTY SIJRa%EY iequl�ed;forall��NEUV�cor�struction.., .
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<br /> Diiections: - .. �,,:��;�;."�• . ..- - .. ,f _. . ._. .
<br /> Flll.out appBcaUan�campletely.J �
<br /> Uinrnec.&Contractcr.sign.back-of.appllcatlon,notarized �
<br /> I if ovsr 52500,a�Notice af,CommencearAent-la r�quired. �,(NC,up8rades over�7500) : �, ,=
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<br /> .Agent(for.tfie contrac.torj_or•;Po�ier;of Attoiriey(fiir tf�e�owrier�would be someone with notarized letter.irom awner suthodiing same
<br /> 'DVER TNE',COUNTERti.PE1tMITTiNG�•,<-_:.:...(Front-of ApPlicatiorr Only) = , - .., . . . .. _. -,.�..- .._._.,.�. ;.q
<br /> Reroofs:if shingles Sewers .�Senrice Upgrades A%C" Fences(PladSurvey/Footage) . � , , .
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<br /> b'rlveways-Not over Counte�if on public roadways..needs`ROW � , - , �
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