|
813-780-Qq20 City of Zephyrhil(s Permit Application Fa�t 813-780-0021
<br /> Bullding Departrnent
<br /> . •s .
<br /> Date Received • .
<br /> ' . - � . :Ptione'�Cor`itact%for`Perntlttln - _
<br /> Owner•�Nam� 1 ;`(� , . C3wner Phooe Number . .
<br /> Owner•s Addre�s , ., , � . � � � Owner-Phone�Number � .� . �.
<br /> Fee Slmple Titleholder`Name=� � " � � �� Own�r Phone Namber ' � �
<br /> , . ---=.��:. , . ; , . - . . . . - . �
<br /> - .. � -. .. . _
<br /> Fee Slmpl�Tltleholdec qddress • - ��-. � - - -
<br /> JOB ADDRESS lSJ 4� � �.� ( I„1��T" LOT# �� -
<br />� � ' , � ��.• �. �
<br /> SUBDIVISION �. �,..:. '� 'PARCE4'ID# � . • . , , , ,
<br /> . . ' ' - � , . ' . •(08TAIMED FRQ14!PROPERTY TA?f'N07tCHj, , .
<br /> WORK PROPOSED NEW CONSl'R '.' ADD/AI.T � �SIG1V [� � � Q� DEMOL.ISH �
<br /> ~INSTAI:L �REPAIR � � -^ ' "`
<br /> ,._ � . -8.,-
<br /> ,, . _ .._. ,
<br /> PROPOSEO-tJS
<br /> E .: , � Q"- SFR,- �`� �`4COMM 'C� OTFiER� `., . '
<br /> TYPE OF CON3TRWCTION..� -`'�]'' `'BCOCK"';,,Q��;� FRAME � STEBL. ,Q:.. +,
<br /> I a�/ �
<br /> DESCRIPTION OF WORK �1 y � . G�,' " bY'1 .., � G •
<br /> BUILDiNG SIZE"� � �'�p:FdOTAG,E��� _ ;.HEIGHT=��;' �
<br /> QBUELQIRIG " v ; ��.:.. . � ....,,�_ _. .w , � . ,
<br /> � `�t�:.d:. ...� ...��.-._-:,:
<br /> . . • `:�,.'.VALUATION bF"fOTAL GONSTRCJCTION
<br /> QEl.�C'1'R1CAC �� = AMP SfRViGE �` PROGRESS ENERGY �[�.� W.R.E.C.
<br /> �PI:UMBtNG .• $Q� /1� •(�,p . , .
<br /> ��� �;.��. , -
<br /> [�MECHANIGAl: ' $' �"�� " VAE.l1i4T10N OF MEGNANlGAL,INSTALLATlOiV �
<br /> � � �� � r. - _ ��7 3 -��
<br /> (�Gas : _0., ..�oo�Etv�::�;:p : sp�ci,a��nr���� .o-�»�� � _,
<br /> FINISHED FIOOR ELEVATIONS FLOOD ZONE AREA �YES. NO� ` � ���
<br /> �I ._ ,a�4u�,� .. � . . ._ ,r r . , ' . ...
<br /> ' ��. _ . -
<br /> BUIk.DER COMPANY � ." - - . •
<br /> SIGNATURE REC3ISTERED Y/ N. - FEECU��"'t;y. ":�Y/.N.:::: ; _ ,
<br /> llddress ' ; ;`,, . � � License# I ' � ^i'� ......�
<br /> � � , . . .. ��:;,. , M � '' - ��
<br /> _ _. _ ;. . , .. .
<br /> EtEGTRtCl/W:>; - ' .� '„ ' CClN'iPANIf . � . . ..
<br /> SIGNATURE �' REGIs7ERED Y/ N �6u�� " " :Y.�/N "
<br /> Address - . � .+.License� `
<br /> . . -.. . # i---- . . �
<br /> � �
<br /> ALUMBER " r � { ` CGIMBANY3 "� S` ��l GX.; �
<br /> SIGNATURE '` - :rtEc3�S�7EREp - .��Y./�-,N! , � �e�cu� n' � �Y 7: .
<br /> �►ddress _ , ' . , .- . � < _ l:lcanse#�l[ - - .. , �
<br /> ( MECHANIGAL`` ' ._ ' - . � .;; , �C�iMPANY - .. . �,-. - • , _ ._
<br /> SIGNATURE � . .° , . .. ' <�;. ` � _I�EQIS7EREDi,;. , ,,;. _Y::/'N- ,::FEE,CURREk , f Y./�N�•.=
<br /> - _ M1•. ..� . . , • ` �,.. . - ... . i:}"; .. �;r ... .. �. . . .,
<br /> Addre�is� • .• .,, � h:..... . . � � . �i
<br /> . ,. . .
<br /> . � : .
<br /> _License# '�:
<br /> .. .. . .
<br /> . : ��... . - ,. _ , . �.� . _ .. . ,:
<br /> OTFiER � . , .__ w.� . ` . � : =-F •~ � ' _COMPANY ` ..".,. � ,;.. h', ...�: : � . .
<br /> SIGN�4TURE. : 'w'r., . : ,., , ,_ :_ , ,.�� ,.,•. � r_: � .. ..
<br /> REGISTEREO. Y/�N.:, N,.EE�CURF3E� �,,. sY:/�N:,.
<br /> �ir�� . _ . _ . !
<br /> 4Wdf688�, . ' -,"'.i. «?;`s'i��;�Jj,{� ,. :.j�'�:�'i"' - .. -. y;t� , , ', .� .; .;��.. .. - .�� ,
<br /> ~uC��§8'�
<br /> , . . . _ .,5. - -,.y-. .'.Y,,.it_�. ��.•. :::,�-=6;':::.:,� �_ :?:�,_,`.:a :i'�.:§' i-3`,r:'t!:.5:�:_a:,..' �:+��,,., . - . �- ,_ '
<br /> � , -: . .
<br /> RESIDENT�AG+.::�:�Attacti(2};Plot;P.,lans•;:(2)�,sets=oitBuildl`ng�Rlans;`(1j`set,of.�Energy��ortiis;'R-O�VIt'Permtt:fo;rrnew�constnupii�on,�,:� + ,. . ,.
<br /> :'�-Mlnlmum�ten:(10)kworking;day,syafter subinitta7:date��Requlred onsite �anstrucdon�Plansf Stomiwater Plens w/�Sllt Fence.installed,
<br /> _.�..;.4Sa�ittary�Fad4itles;��1}�du�ipster SltewVtiloric�Perxnf[_foc:sut�t�isloristlarge'pr�ojects::.�;,��.�_�.~ . � - •- ' . - ' -
<br /> COlVIMERCI�4l. Attech(8j cbm�plete se'ts af'Bultding'Plans ptus a'i.tfe Safeiy Page;(1j set of Energy Forms'.R-O-W Parmit for new cbnstruction.
<br /> Mlnimum ten(10)working days after submfttal date. Requlred onsite,ConstrucUon Plans,Stormwater Plans w/Sllt Fence installed, , , •
<br /> ,, ;
<br /> Sanlmry Fadiitles�,1_dumpster..Sfte Wotk.Perm[t:fo.r�ll?,new proJei�:�i411;cammercdat.eequlrements must meeYcompilance
<br /> SiGN PERMiT Attacti'(2j sets of`�ngtneer,ediPPa�is�;�;���:r:� .. _, . � ' - ' . „ �
<br /> """PROP,ERT_1!SUR1%EY r uired fqr;all�NE1N:consWcdo[i.,.__, � � ��� " � � � .
<br /> 89, -
<br /> - Dlrections: .�,� . . � _ .._�. __.._. _....�. �... .__ _. , .
<br /> Flll out applicaUon oompletely.
<br /> t�wrner&Contractor.stgn back:of appllcaSoa,notarized
<br /> If over!6�500,ar.Notice cf..Commeacement ia requlred, .(NC upgrades oyer s750Q).,, �
<br /> .. �t;�,::;;<,�,g:r,�:�.�,- ;.,,.._�.... _ :.__.: ._.,� , ..�.. ... .. _ ,�._ . . _.vw .�'
<br /> Agent(for the conUacto�)`or'Pow"rer of�Attorti's`y'(foi�the:owrier)'woutd'6e someone with notadzed letter from owner sutho�tzing sar�e
<br /> 'DVER THE"COUNT.ER.PEkMITi1NG�=�,�-(Fiontof�i4pplicatlon C1nly}�'= ��" ^ V � � ._
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences_{PIoUSurvey,/Faotage) _ _. - -
<br /> .._;., ___� __ -:.n�� �,. - - -- . =. ,; �=;',:� -� ,•;,. . , ,_
<br /> „�,:�«:.::>::"x:�'`, ` _, '
<br /> Driveways-Not aver Counter if on•publia roadways..needs ROW
<br /> _,i:.*.=-�
<br /> - � ,
<br />
|