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e��-�saooao Ci#y�of Zephychills Permit Application Fax 813-780-0021
<br /> • Bultding.Department
<br /> �at�Piecelved, - - Pfione Contact'for:Petmtitin -':''.:`�- -�_ �-._ -- -.. _ ._. � ___,
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<br /> Owner"s Naene ,� _�;°!+ L C�e r, - - - � o�vner�tione Nuiiiieer`� �3� Cn�� �'1�< 0
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<br /> Ow�er's Address ��d� ��� �� � Owner•Phcne Number �
<br /> Fee Simpte Titleholder.Name � � � � Owner Phone Number �" • �
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<br /> Fee Simple Titlehoide�Addresa ' " �
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<br /> ,�os�wo�ess ���'iQ ,.:`� 1�t � �e 4�3 t �t�'1� s+, M � ._ _ ,_.. �oT# ��
<br /> SUBDIVISION' ' :��� � . PARGEL!Q#' '� - • - �� , .,. :- . ` _ `.' , � - _.. ._". .
<br /> . -, - � , , ' ., . ' .,, ,` � ', '(OBTAINED-FROM�PROPERTYTAX NOTICEI," , . . -
<br /> WORKPROPOSED , - , 'NEW=CONSTR •.�-'ADD/ALT ��' SIGN:'' [�;" ". "` . 'Q�f`�.. bEMO�ISH f -
<br /> ��� IiVSTAI< < 81. REPAiR _ � _
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<br /> PROPOSER:UBE; ' Q 'SFR 'Q ` �CfJMM' �' , -OTHER. . - r' �tT•?�N ; , i..` � : -
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<br /> TYPE OF GONSTRtlCTiON.z. � :Bi:OC1C ~' FRi4ME STEEL - ' ` - "�
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<br /> QESCRIPTtONOFWORK °� �t, ve, G.� {lNc� �N $"�/� � �t�.b� G,�oo�_>::��
<br /> BUILDING�SIZE`�'��T � �SQ.FO,OTAGE: Cp b , . :- =,HEIGHT �'� , .�. , -
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<br /> QBUICDING •� ,:,`�,:=•-=.. -:- . . ..�;.,,,,.;.,. .
<br /> , $ �� G"� VAL.UA710N-�`JF Tl"?1`Al`COlVS7Rl7CTION � ,
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<br /> QELECTRtCAI . $ - AMP SERVICE Q. PROGRESS ENERGY [� •W.R:E.C.
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<br /> QPLGMBiNG. � $' _ rli,
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<br /> QMEQHAiVIGAi. $ UAI.UATtON OF MECHAt`SICAL tNSTALtATIOIV. -
<br /> QGAS Q, ROOFING�,-Q SPECIALTY.�.. OTWER � -
<br /> FINISHED FLOOR ELEVATIONS ,'�� FLOOD ZCINE AREA �YE$ NO
<br /> BUILDER � � ' ., -:COMPANY ��6Y1 O"r`� T�✓1 Cc.. �.(,C �
<br /> SIGNATURE �'t--v ��.M-� R���s�REo Y/ N , FEE CURRE� -,Yl N�,.�,
<br /> Addre�s � . Llcense# 14�, !2.�'Ce i y2�t" �,5�-6d�-lD�a02 5�'
<br /> ELECTWCiAN CCIMPANY ' � �
<br /> SIGNATIIRE �' REGISTERED Y/ N FEE GURRE�• �.Y.J N -
<br /> Address s , e_ l:fcerise�#.=��� ' ` '� � �
<br /> PLUMHER . COMRANYr -
<br /> SIGNAI'URE ,. .REGISTEREp • :..Y fvN :; . �e Curt�n Y!N: :.
<br /> Ad"dress ' . . . �`,Llcense#�(� . - , ,�
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<br /> MECHANICAt ` - � COMRANY�
<br /> SIGNATURE ' . . ' `` REGISTERED. , :�-Y.;/:.N� . ,. .�e CURRER • Y/N` :�
<br /> Addre�s ' . .{� � , ' - - Ll.Ce�se:#�_C� � �
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<br /> StGNAtURE' . " ' ' .REG!^.s PERED Y/�N. . k FEE;_C,URREh, �ti Y./;iYi:: I
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<br /> Addresa ;r�.t:� - , . , - ` - ' 'Ucense�#
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<br /> .:�� .,."�.-' .,i•1:`"a'�d?t��Y""�a*;t'-'"£t`�'1;. ,�^ - ���M�r�'.� nU:c..;�i'Y:;�.+.
<br /> R DENTiAI r �Aftacti'2'°Pio r.P{a'n �A s"` '�ofBuNdln -P ans�1 se#of-Ene' Foriri's`R�O=VU�Perrnit fdir.new conshuctCon ,. _.
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<br /> .�;:.=:�Mlnfmurtt�ten;(�1Q);wotkin.gyd�ys�attet�sulimit�ai.ilate=:Requti�ed onslte;kGoitisinacHbii'Plans;;SforinweterPians wI.Stlt Fence instalted,
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<br /> Sanitary�Fadlitiest&t1£;durtips,ter'SIte�Wor,fc,..P,eiwrtilEr#or�votidlvlsiohs/large-projects�`"�':"'_'�:�'�<'�,�;;�..�' ` . _
<br /> COMMERCIAL Attach(3)'cbmplete`'`s,ets of Buildf`ng'Plans,plus�a;L-�1fe;Safe,ly:Page;(1):set of:Energq F.artiis.RA W Permitfo�neiN�constriicUon:
<br /> Mlnimum te»(90)vrroiking da}rs aite�scitimlitat date. Reqalred ansite,Canstruc#ton Ptans,Starmwater Pians w/Siit Fence instailed,
<br /> Santtary Fadl(tles S 7.dumpste�..Slte^Work Permitfor,a�l`new;proJects:.i41!commercial�cequtrements�must.meet�compllance '
<br /> StGN PERMIT Attach{2)'set"s cf"Eng`ir%eefeii�Plans;�<,.�,�:�:�;� i ' , • -
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<br /> •"'PRGIPERIY 3UFtVEY;reguired tor"at[fV�W ccnstntction._ •
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<br /> Fttt.aatappttcallon c;ompletely.
<br /> Oiwner..$Contrackar.sign.back-of:applicatlan,nata�ized '
<br /> If over S25Q0,a�Natice of.,Commencem�nt,la requlrvad: .(A!C upgrades over�7500) , -
<br /> -�,:..a.sy,.t�'Cu"�1'k.l,.:i` �
<br /> "* /�qent(for.ttie cbnUactor)q7'Power;of Attortiey(fo��ifie owrier)would be,someone with notarized letter fram owner authorizing same
<br /> ' 'DVER THE'COUNTER;.PERMI'xTING,y-- - .(Front-of-Application Only)
<br /> Reroofs if shingles Sewers i Service Upgrades-A'/G': � Fences(Flat/SurveylFaotage)
<br /> Drlveways�Not ove�Counter.if on public roadways..needs ROW
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