|
�.,-..""
<br /> � 813-78b-0020 City of Zephyrhilis Permit Application Fax-813-780-0021
<br /> Building Department
<br /> . Date Received ��5— I �p Pha�e Cantact for Permitting lJ`� �V� -- ����
<br /> �weeer's:Name O'�I S 1 � 1(�..� I n�Z Owner Phone Plumber C��•�j aR�� `� "'�
<br /> . ;�- .
<br /> '' .`"� "' Sa�j �°�'n �-1-{ee-i- (� (h�II 3�5`Ia owner�hone.i�umber
<br /> O,wrie�.s�Address.;,. ,
<br /> Fee Simple Titleholder Name ' Owner Phone Number
<br /> •Fee Simple Titleholder•Address � ,
<br /> JOB,a1DDRES�i 5��3 lY� � h `h i�IS F I 3 3�5�1 a �oT# [�
<br /> SUBDIVISION, ' � �� � �1 (hi��S 'PE4fdCEd::ID#, I"��^��— ��I b—�py�b— ��
<br /> •, . , " �(OBTAINED FROM PROPERTY T�JC NOTICE)
<br /> WORK;PROPOSED:, NEW CONSTR ADD/ALT Q SIGN [� MOVE Q DEMOLISH
<br /> � � "` e � INSTALL � REPAIR J
<br /> PROPOSED USE . , Q SFR Q COMM Q OTHER e - '
<br /> TYPE OF COPISTRUCTIOfd Q BLOCK� � FRAME Q STEEL Q OTHER
<br /> �ESCRI.P;•TIONzo�3Wa��, � �ea� � �t�'rcx� I� S �re5 ��4� i ��n hQ.r��� as h�,c� �h i�l � .
<br /> BUILDING SIZE; • ,Si�;FOOTAGE' I�� � HEIGHT
<br /> Q BUIL:DING . $, ---� ; - ��,,:._..�,.�._ , : • , . „
<br /> ';.. <r,� ?.VAL6IATION':�F TOtAL.,CONSTRUCTION
<br /> .�:���;'��_ ... , v ..... .. •
<br /> � ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R,E.G.
<br /> � PLUMBING $
<br /> ' � � . � � p U
<br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �i�'� � �
<br /> � . { ,
<br /> Q GAS � ROOFING 0 SPECIALTY Q OTHER � ��I D �
<br /> FINISHED FLOOR ELEVATIONS ' FLOOD ZONE AREA QYES NO
<br /> OUIfl.DEi� ' COMPAfdY
<br /> SIGNATURE ' REGISTeRED Y/ N , FEE CURRENT � Y/N
<br /> Address ' License# '
<br /> ELECTRICIAN � . ' COMPANY - �
<br /> SIGMATURE REGISTERED Y/ N �FEE CURRENT �Y/N
<br /> Address � � ' License#
<br /> PLUMBER COii19PANY
<br /> $IGMATURE ' REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address License# �
<br /> MIECFIANICAL COMPANY �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y I N
<br /> Address � License#
<br /> OTH�FP�$:� _ - - --CC. � . LI.�U(�'� ;COMP.ANY, � NYIQ� �(��1� �1C� ' � ,
<br /> SIG�6VA'�URE�� -- _ - - 'REGI3TER�D / N FEE CURR T /N
<br /> ,•Addtess �3� � S h (�'111� S f�� 3�5 1 � ��Ucense# �CC-��2 s���
<br /> ;v • -
<br /> RESIDENlTiAL Attach;(2).Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, -
<br /> ;,Minimum ten(10)working days after submittal date. Required onsite,Constri�ction Plans,Stormwater Plans.w/.Sitt Fence installed, .
<br /> � . Sanitary Facflitfes�&'1 dumpstet;Sife Wark Permit for subdivisions/large projects ` ' . � , •
<br /> COMMERCIAL � Aftach�(3)�sets of�Building Plans;(1 j set of Ene�gy Fomis.R-O-W..Permit for new construbtion: �
<br /> Minimum ten(10)working ilays after submittal date. Required onsite,Constiuction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All�ommerciai�requirements must meet compliance� � �
<br /> SIGPI PERMIT Attach(2)sets of Engineered Plans. . •
<br /> *"'"PRQPERTY SURVEY'requireil for all NEW construction. . . . , --. �
<br /> Dlrections: ' ' ' • , ' ' � � �
<br /> Fill out application completely�.� , .,
<br /> Owner&Contractor sign back ot application,notarized ' �- � ' � -
<br /> If over$2500,a Notice of Commencemgnhis required. (A/C upgrades over$5000) -- -=�-- �-`
<br /> ** �Agent{for the•contractor)•or�Rower,of Attiomey(for the owner)would be someone with.notarized_�etter from owner authorizing same
<br /> 'OVER tHE Ct�l�N7ER`PERMiTTING`�,��;(Frbnt`of Application Oniy) :' �.:t =: j. .. ; ... -- ..� , . �_I_`
<br /> �Reroofs � , � 'Sewer's ' ' 8erviCe Up�rades A/C Fences(PIo�Survey/Footage) � - � . ��
<br /> � , , .�,�.. :. , ;;,�,••. � ; , , . �� =��
<br /> ' T� � '� �.� ';� % �:j.:�6t''�:.` ,1 .6.di
<br /> 4'„priveways�;Not�ove�,�ounter-if ori:pu6lic.raadways..needs ROW �'� _ _ � _ �_ �� �i. ��''�„�.;.,:�
<br /> ' . . .� .f, y . _. . i..�o-`e r�-_....a.-u.�.-��... r..-r..s, ,. v..,.,Y��' i. c.w i... .. �
<br />
|