|
s�a-780-0020 City of Zephyrhilis Permit Application Fax-813-78G-0021
<br /> Buttding Departrnent
<br /> , •• .
<br /> Date Recstv�d , � -, �, ,
<br /> �: Phoa�,Coritac#'fdr`Parmiftln"`::` -
<br /> r,,. . .. , , . . . , . _.
<br /> Owner•s Name / rv �t�vt w1 Uwner Phoa�Number '
<br /> / . : . . : ,���,�
<br /> Ownar's Address ..7 � �- Ca Y Q C h ��.h r Cf • Ownerphone�Nii�nbet ff � .
<br /> Fee Slmple�TlBehalder,Name ��_, � . �� Owner Phone Number I ,�� � .
<br /> � �3'!` _ . ,
<br /> Fee Slmple Titl�holder Address " �-;`s � ' -
<br /> JOB ADDRESS � � D � C��� �h 1�.r� G� � � ��,, %�,r fi! 3 3-5 Lf� �o�r� �,�,�
<br /> SUBDNISION �: , �� ' 'PARCEL'ID#"�, � r' z�' '�2I'�U I � d ^00(?'Ob ^O� ��.
<br /> _ ' ' - ' - • � :_�(OBTAINED FROM PROPERTY TAX NOTICE). �
<br /> wORK PROP..OSED �- NENv caNSTit ' ADD/A�.T � SIGN (� -Q�"` .DEMOLISH •
<br /> _: � � . INSTAI:L = �.� REPAIR� ' � - '
<br /> PRpROSED USE - . _ [�; SFR �' � "COMttii!�. � OTfiER� ";
<br /> TYPE OF CONSTRUCTION,;'� �Q BL'OCK�' ;�Q� ,F�AME �,� STEEC, � ��
<br /> ,�. .....
<br /> DESCRIPTION OF�WORK U�--L r v� �� G�I��_ T(.�,�i•-�r�V e 3 U S : � ���.
<br /> : � -� � - -
<br /> BUlLDING SiZE�� � $Q.FOOTAGE��. . , ;;HEIGHT�.�. �_:
<br /> . QBt1}IDING , $ �=-�;s,;,.;��. �,�r,n,..r,,._ ..
<br /> . , , ��C'"(}Q!�► t�' VAI:UATION OF 7'O'i'AL=CONS1`RClCTION
<br /> [�Ei.ECTRICA� �� AMP SERVlCE 'Q PROGRESS ENERGY [� W.R.E.C.
<br /> QPi:UMB1NG ::$ .
<br /> :. . �. � .,4"C, , ,.' , .; ' .
<br /> . , .';,r_ ,
<br /> QMECHi4NIGAl $ .—��. : y V11t.tlRTION OE M�GHANICP�I.INSTAt.LAT10(+� . -, �
<br /> QGAS . [�] �,R�OFING:�r,0 SP.ECIALTY ",��' OTHER �
<br /> FINISHED F1,00R ELEVATIONS FLOOD ZONE AREA QYES. NO . ,
<br /> � �,_� . - - ' ' ' .. , . _ � •
<br /> BUtL.DER COMPANY� ` ' --
<br /> SIGNATURE REGISTERED Y/ N. �e Cuw�E�" Y/.N •,
<br /> Addreas - . , �, _ ' License#i�t .. �
<br /> , ,. . .,. �� '' �
<br /> El.BCTR1CfAitt� , , - - � , GOMPANY � .,, , . , _ � ' -
<br /> SIGNATURE + �"' �G�srER�a Y/ N �cut�n, `Y/N .
<br /> - , , .
<br /> Addeess . - - �L•icen"se.#�� � ��
<br /> PLUMBER ` . � � � CQMP,ANIf. ,- ,, ::;; " ; „ ; ,
<br /> 31GNATURE� - `'� 4 . , �
<br /> ��.- . . :�Q�s.r��a: ,�. .;.Y/�4N• ,, �e:cuw�en �Y�;N:.
<br /> Address . -. �. y - , . , ..Llcense# � �
<br /> MECH11N1C1�[:. , - - . � . - .. ;GOMPqNY ' . " •� _ - •�
<br /> SIGNATURE ` . . `": . . � - . „ - , REGI�STERED:; , , ..Y./:;N.., ,::FEECURRE�'; . "'Y'/rN.;,�. , ' , .
<br /> �ddress;` „ ,- , . , .�., - � . ,_, .,. -- , _ . �'°- , �..Llcense# j. .;�- ` :�� . �� _
<br /> OTHER ` ' _ _ u .'�=.; . . y/� �-7-
<br /> .., - .. ' - : _ - _. , - . . .- _ ..
<br /> :CiC11111PAN1! �:U� ,f�!LGIt HL'.;st� ,: G.U:r,.°;''` ,..i.-:0� f
<br /> SIGNATURE. . . ` `
<br /> �REGI97ERED. Y/-N�.<' FE�iGURRE�' t� f:Y�/;N_;: .
<br /> ., : ;�, :°a-��,�:, ;;� . ;;--� � .+,.,:. ... .v z. j.',.. .a S�y'_ ��.��r . - ,,,,, ,_.-.� .��c:��~ �9'� 7 �
<br /> �dreas 3 .j': _� �`� .�;�y�' j ;�-�-" `iJcense"#� �
<br /> 3 �
<br /> .r�A"..�:.. � r..�/�� 'j��y r�£�a:(,�p"..r'. ' . `
<br /> : ' � { .+ _. _ ,'-t, ' .a-. ;, y�__ " .' y:'I..'r � �.�`§r �WIFSVMY$Gn ._ .. e r
<br /> � RESIfi}E�ITiAI:,_.;=Pitkacti�{2)..P1ot:F',tans;s(2):sets=of:Bu�l�lrigrF?lans;.(4}'sef,af.=Erier�yr°�Faiisis��R-0=tlttxPerrii'it:fo7.r��ir;;,, . - . - ,
<br /> � �. �_�- ..
<br /> _::..,nMlnirtiunn�,ten(F1Aj,fworlting;day,s=atter�sutimittal�'tlate:;Requlred anslte;Con"sfruction•Plans Stor►nwater```Plansw%Sllt Fence�installed, � .
<br /> ", SanllacyFad4{tl@s8��,l�dum�sterStteWark�Pe�nftfor.�ubdlvisfonsllarge•'pcaJect's'..,:�,;ri��=._:-',• ;:,- '� : � :� . �� .�- . -
<br /> COMMERCIAI. Atkach(3}coinplete=sets'of Butt�l'ng Plans plus a'llfe Safety Page,(1j set of Et�ergy+Farrns.R-O W Petmit far neW canstreic�ton. _
<br /> MlNmum ten(14)working days'aRer submittal date. Repuired onsite,.CansWcUon Plans,Stormwater Plans w/Slit F,ence Insfalled,
<br /> San!ffiry_Fadtitles.t�,i dumpster..,Stte:Work_Petmttifor�il:new`prqjacts:Ail.cammerciai,caqutrements_ritust meet campltance _
<br /> StGN.PERMlT A#tactf'(2)sets o"fi�ngiiieered=Plar�a:�;;;.i��r �,;.` , . - , •.. . ` . �_ -
<br /> •"""PROPERN�SURVEY:.regulredlqr.all NEW,consUucflon.;_ - �� . : ' , -, • � .
<br /> D�f6C�0i18: _:�,.�:�;i....t.,�_�:4' - _ -_ _'_ _" . _" _ _ - -,.
<br /> FIII:out appllcaUan completely.
<br /> E�wner 8�Cantracfoc sign bacic af.applicatlan.notarized
<br /> If over 52500,a Notice,of CommencemeNtla requlred. (AIC upgrades over_5T500),_... . ;, . .
<br /> __. ..__.._:_._... .:_._,,._.._._, � _ _ -
<br /> .. • i�<z„�Y�'j�,<''•t'i<�:a�,;.`.. ,.. . . .
<br /> Agenk(far the cbntractar)'or:Powe�of-Attomey'(for ttie'owner.).would be someone with notarized letter from owner authodzfng same
<br /> d,VER'THE=COUNTER:PERMITTING,_:.-,:.�.(Froa9t-of=J4ppltcation Only)__"� < � . � �. �. _ _ �
<br /> Reroafs if"shingles Sewers Servtce Upgrades �NC •� Fences(Plot/Survey/Footage) -- - ,,
<br /> ...s�t.. ; , .3 _ ..,
<br /> Driveways-Not aver Gounter if on•pubiic roadways.:needs RQiN� _.--_- � �
<br />
|