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813-780-0020 City of Zephyrhilis Permit Application Fax 813-780-0021
<br /> Bulldl�g Departrzient
<br /> Date Recetved r;��f ji � . � � ��- 7t„�;:��"j .
<br /> i'" Plione�CoiitactAfor'Fe�rmittl`n"' .;
<br /> Owner'�Name . �-- . '-`�(. C3wner Pboae Number ��� ' � 2-^�
<br /> Owner's Address �J ` °c OvirnsrPhone-Numbsr �� '� �
<br /> Fee Simple Tltleholder Name • �"� �� "•� " �� Owner Phona Number ��
<br /> . r��.�. . . , :, , , .. . � �'� � ,
<br /> Fea Simple Tltleholder Add,ress .'. -�>, _ • , .
<br /> JOB ADDRESS UL��� T�� LOT# ��
<br /> SUBDIViSION � , .. � PARCEL�ID#~'' � ' � •
<br /> , ' . , - � - > > �(OBTAINED'FRQM PROP.ER7Y TAX NOTICE) �-
<br /> WORK PROP4SEp ; ' NEW CONSTtt ��' '�' � ADEi/A1:T � �StGN 'Q - �Q"z� DEMOLISH • .
<br /> . .- e' ' `'INSTALL =-��8 �� RERAIR' - .�
<br /> PROPOSED USE.- ., , Q` °SFR � CQMM'. ,� "OTHER` � '
<br /> TYPE OF CQN3TRUCTION�` ��] ' "�BLOCK�'_�'Q`"' �� FI�AME � STEEL _[�] . �
<br /> DESCRIPTIQW'OF WORK x L� ✓��U l�C �� �� �
<br /> BUILDING SiZE� '�.. j� .
<br /> � � S.4.FOC1'i'/►GE�. �� �yHEIC�HT� .I.R•'�.�,,,�_
<br /> . QBl}1LDItVG $ r-.�Z,,., .. . �#.�.�;�.�v. . ...,,.;,�,e..__�.' , . "
<br /> ��� ��"�"� . . .VAL.UATION OF`TOTAL CONSTRUCTION
<br /> L�J=1.�'; �, _ . ,.. ,, � .. � . . , . .
<br /> QEl.ECTRtCAL �� AMP SER1/ICE ��Q' ' PROGRESS_ENERGY [�� W.i2.E.C.
<br /> QPLUMSlNta $
<br /> . C .,._ � , , . . - , - 3
<br /> OMECHANIGAI $ �VA�UATIOh2.OF MECt1AMICA�INSTALUiTIOi+! - �:,,,� � � �
<br /> Q GAS 5 .. [� ROOFENG::•<Q SPECtPd.Tlt �� Q3HER �
<br /> FINISHED F1.00R EI.EVATIONS L�� FLOOD ZONE AREA QYES. NO ,
<br /> BUi�DER �/ �`/�L/ COMPAFIY� ``;� . ., � `
<br /> SIGNATURE Lli'?�LG�G�- ���Y� RE(31STERED Y/ N. �e CUWtEn' ,,,, .Y/.N �. ,, � ,
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<br /> Address � 'Clcense'#'�� '� —�
<br /> EtECi'ftlClAN_>. . 5 , . �, " ' G{lMPAf�IY ~ ' ` � � • ` - _ � .
<br /> SIGNATURE _ "' RECaISTERED Y/ N FEE CUFiRE� `:Y./N
<br /> IB►tIdP8S8 ^ � ,- .. _':(:IGBII§9-#;•�-_ 9 `�
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<br /> ��uut��R . coMF�nr� ;� - .�
<br /> SIGNATURE � � -- �RECi18TERE0. _, �°Y,lrtN �<� .. FEE:CURREk.'`. Y/`N. '
<br /> Address �'. - . , . � ..License#�� - �
<br /> MECHANEGAI:' , . .. . _ . - ' ' ;GCNiP,ANY•: • , � � .. , ' - . -
<br /> SIGNATURE '` . .-�" ,: , - .� - . _ REGI�STERED;, JY:J=,.N-, „ `,- ,r - � ` � ,
<br /> 'x. � �:�cu�n ,'Y-�-W-, -
<br /> Addres�`: . ax _. >. _ _,. � .-� .. -- - . - ,.4 .. � ., ; _, . ..ucense# ��-- �
<br /> O'iHEi� , ` .': , . _. .,• � - , .:.yCOMPAt+IY„ ,, ; , z . - . . . , � , , ' -
<br /> SIGNATURE.> . , • . . , , , _ _ � ,. �,REGis`r�REo. �Y/'N. .���'Cu�n Y./H. , s'
<br /> �k:; ., -: .
<br /> Alddre�s > _ . _j ;s`;� _ .. ,-::.. iz:,' .� �.. � " - .' tir.i�nse#� A ,
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<br /> EtESIC1EN1'IARc:::.-:�R#taotir�2��:P:,lot P..1aas„2 ise#s>-oftiBull`d1n "Plans;.`:1`set bf.�Eiie �Farins���F2-0=W�Periiil#;fc�'n�`constnic�bn�:..- � , . .
<br /> ,�. {.� _ {.} ... 9 ( }. �Y. ,. . ._ ,.. ... .- �+;........., ,
<br /> � Mlnimumrten°(.'19)'�worlttng;daysiat�er�'s'utimlriaf-date.��Required,'onslte;:ConsirucBori-Plans;�•StoimwaterPlansw%"StltFencetnstalled,,.
<br /> "... , �Sanlfary Fadlldes;8:1:,du�qster�Slte�lNoilc,Pemiit.foi,-subd341'slon�Aaige�piojects'<t��i-�-#gxr`::'. � � - " . _ _ . . , - �
<br /> COMMERClAL Attac�{3j�oai'r`EpleEe sefs of Bultding Pie"ns plus a'Ufe'�Saf+ety Page;(1j set of Energy Fatms.R-0 W Perrnit far new c;aristnic�tion.
<br /> Minimum ten(10)woricing days after submlttal date. Required onsite,.Constructian Plsns,Stormwater Plans w/Sllt Fence Installed; . ,
<br /> Sanitary Facilities..8�_1•dumpster...Site�,Work PermtGfcr ai!'neinr.prqjects:�Alijcommerctat�requlismenfs-must meet compilance � . - . �
<br /> . $1GN PERMIT Attac�i(2}set§of'�ngine+ar±�d:P.lar�§:;,; �:�t-�-��.: . � • _ • , . , _. '
<br /> .««»PROPERTI!SURUEY reguired,fio��al1 NEW;cons.tructlon; � "" � � -, � �' „
<br /> DirectFon�: �::�:�;.r.��.-�-:. . ...,__.4_� ...--- .. _
<br /> F(II out appHcallon completely.
<br /> Owner&Cantraotor sign:badc.afappifcatlon,no�rizad _ �. _
<br /> ff aver S�SCO,a Nottce�of Commencement ta requlred. (NC upgrades oper S750Q),_ . �: . � � , � `-
<br /> .. ,cr,;t'il'�''°;S>+�:�F.;.,,�._.�w:�. _ _ �,. t - " — `'; . ,-
<br /> Agent(forttie'contractor)'or:R"owei-eYAttoiiiey(fo�it►e.�owner)woul�:be'.soineone with natarized lettsr ftam owmer authodzing same� '
<br /> v.: _�__�..,F: - - .. . . . . ,. ,
<br /> dVER THE=COUNTER.PERMiTTfNQ��=�'-':"(Front:of�AppticaBoi►=Only);'� �` �::` , . " . �
<br /> Reroofs lf shingles Sewers Service Upgredes,;A/C,. . Fences'(Plot/Survey/Foatage) _ ...--. ._..- . w--� -$ -
<br /> .���._,_w�..�v__..i.,.,�_.,_w �. � �,._.:, .,. -, : ,.;:��,;ii.�:��� . � , ,,;; . - - - _.. �: „
<br /> privsways-Not over Cou�ter if on publlcwroadweys.:neeiis�ROW " - '
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