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a�aaeo-ao�o Ci#y of Zephyrhilis Permlt Application Fax 813-78Q.00z�
<br /> _`" " 8u{Idi»g Dapartment
<br /> Date Recelvsd .., � Rhone Goritact°sfor'Ferinittiii � .' - . � '
<br /> �n-Owne�tYame , � � - ' Oxraar PFsone Numtaer f� �� � �
<br /> t3wner's Address ' . C4w�er-Phone Number �` �
<br /> � ` ,., � � ..
<br /> Fee Simpl�TlNeholder'::Name�� � - � � Owner Phon�Nuri�b�r � _ � .
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<br /> fFee Simpl�Titleholiler'/�ddre� - e' '�._ , - �
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<br /> .�JOB ADDRESS � J'� �" /t ,fy�7'# ��
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<br /> SUBOIVISION � : � PARCEk iD#' ` - � .
<br /> , , ' ' ' _ , ,'; •(O$TAINED'FRQM-PROPERiY TAX`NdTtCE) .
<br /> W06t0(PROPOSED : NEW CCINSTR � = ' ADD/ALT �� SIGW [� - `�� DEMOUSH
<br /> .�'�-e �� 'Y INSTALt --e: �. :REPAIR = . . , .
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<br /> PROPOSER�USE . [�� ' SFR' " Q COMM,, Q OTHER, .. � - .
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<br /> TYPE OF CONSTRUCTION; �Q "'BLOCK��• 'Q , FFdAME � ,ST�EL _Q.: � , �
<br /> �DESCRIPIYON`OF WORK � _ _
<br /> BUILDING�$IZE� ,�. . _ �. .
<br /> 3 SQ FOOTAG�, _ _ , ,�FiEIGHT t� ��
<br /> �� �` QBUILDIiVG ($' „�a;�.�:-�. _..�=.:mH�:.; ' �. . Y ;.. , ,
<br /> . I r�^ VAl';UATION"OF'T'tOTAL'GONSTRUCTION _ ,
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<br /> QEI.ECTRICAL ; ($ ^ � AMP SERVIGE �Q PROGRESS ENERGY �[� W.R.E.C.: -
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<br /> [�PLUMBlt+lG :$ .
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<br /> QMECHANtGAL '$ � `, ttAl.Ui!1TION:OF.MECHAN!!�4L,tPVSTALtATtOiV �� �
<br /> QGAS .Q ROQFiNG:� Q SPECiALTY � OTNER `- '
<br /> FINISHED FLOOR ELEVATIONS [�� � FLOOD ZONE AREA �]YE$. NO
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<br /> �UII.DER � ,o+� �� GOMPAP+iY .. `���-�— I
<br /> SI(3PIATURE / �� REGISTERED Y/ N; FEECURREA' � , .Y./_N,:.: . .
<br /> Addre�s ' `, ' Llcense# � - �
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<br /> ELEC7RICtAN�:�_ � � . �� , � � - . � � � . �`� ..
<br /> „ COiVIPAPiY
<br /> SIGFl�►YURE �' REGISTEREp Y/ N FEE GURRE� `.Y:/N� � `
<br /> Addre�s , � , �°.License,#�;1 � ' ���
<br /> PLUtYIBER .. ,GONIPANY,:1 " , . „
<br /> SIGNATURE ' - ' , :REGis.7EREDa� ,, :y/-,N.� , ,F.EE CURitEF'' .. '.Y/'N:`: ` ' " -
<br /> Address .� i � p. .L:jcenseY#���.•, ' - �
<br /> MECt�Ua1Ni�� � ` - , ,, . _ t� �C,GiiYi�ANY�� z _ . _ . �- `
<br /> $IGiNATUR.E ' - • ,f�EGISTERED_' � , Y;/�-N; .',FEE'.CURREP, . Y/�I:r." .
<br /> �lddres$'.�:.. - , . , .. :.�, . , ..� . . .. � .. -� { " ` Ucensa.# �,: . . - �; .
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<br /> OTNER : ; . .. . .. ��' ., � . ' ,.GO�YIPANY� , _. . �.i.:,�;_;- �v.�: ;.� ...
<br /> $IQNATURE. `�! ." - , ` ` _ � _ ,REGISYERED, . . ,Y/.N.a FE�CURf2E��' :Y../. . . . .
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<br /> °- - ..,54 .,. ., � ^ .. �k.Y•+ a, ' ,. K ,� �..
<br /> ��P688 ''f.z, ;�c§" :�ix;l�;..{,u .. . . . ' � � � �CCIt$9#
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<br /> ;�t' �i't :-�•. `�t' ' ' "
<br /> R SItiEN AL,: �.A; i�i`2.P10 Plans.2�sets tif;Builtllit'�''Fians•`��1�.seti�lfEn"'eLL '�Fotms��R=�=NU=Permlt:for ev�:coiistruc8bii•;�.� .
<br /> � Ti...� �-��i. .#ta .,(..},,.3,�. �. .� . ... .. ...:... 9. , �.t..�,_,,..,,.,• r9Y..> c ..4�,; ,
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<br /> ,.;��S;IiAiniinum�ten�(�1Q:�vicorking�,day's�,aftetcsutimlttal�datet%Requlceif;onsite';;C:onsfr,'uicdon�P„Ians;tSfamiwater,.:Pl�answ%`SIIkFence,installed,. - .
<br /> �`. �Saiiltary Fa��itlets&s�3�d��m�st�r;Sitey,YVoc�c»Perr�it':�;,sutidiv.l'siotts�latge;proje��, a f�.�,' �;;.:�:u`�-'" --._.w _.:,� •, � � .. �
<br /> � CONI�ftERCiAL At�ch(3)eompiete'sets of SGliding Plans plus a lffa Safeiy Page;(1)set of�nergy Fortns.R-0=W Permit for new cbnstructlon.
<br /> _ . Minimum ten(10)working days'aRer submittal date. Required onslte,,Constructlon Plans,Starmwater Plans w/Silt Fence Installed;-
<br /> SanJ#ary Fac�t�t��8,1,dumpster.,Site-Work•,Pstmtt�c,sr aii�new'piojects:Att_'commerciai�cequirements-must•meet compitance . �
<br /> SIGN:PERMIT AttacFi(2j sets of`Eiigt�i'eer`,�di.Ple��ls:S�a�'�;~s''�_,,:.. _ , ' - . . - .
<br /> "`••PROPERTYySURVEY r�yyulred;;fg�;.all•NEW�,00nstruCtion:.~ - - - , -� � -. .
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<br /> pirectlon�: __�;-x:�. .. . _ _... _�. _ .__._�_ _....__. �
<br /> FIII out applicatlon ccmpletely.
<br /> Ownat:8 Cantraator.sign back;of appltcattan,natar�ed
<br /> If over 52500�,a;Notic�of Commencement ts requlred. AlC upgrad�a aver,37S00 ,,. �. .... `
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<br /> f1r ' .,..75v ).C3 .;_ .. .,. ..� .. ,.... ,. . . . .. -..
<br /> Agent(for.ttye coottacto�)`q�:Rower-ofAttoinFiy(for the owner)would be someone:with notarized letter frnm awnec authorizing same
<br /> °OV/ER'THE COUNTER:PERMIT�'INGr-:�=� -(Fioiit�iaf�i4pplication`Orily)�`�. �- �� ;
<br /> Reroofs tf shingles Sewers Service Upgrades A/C _ Fence�.(Plot/Suryey/Footage) . -�... -•-- �
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<br /> DHveways-Not over Counter If on public roadtivays.:rieeds ROW
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