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813-78Q-0020 City of Zephyrhilis Permit Application � Fax-813-780.0U27
<br /> Building Department
<br /> Date Received , ,:�� •�� -phone Contactafor'Permlttin ��� `�� ` -
<br /> Owner's Nlame � 1 l�� ��� Owrner Phone Number
<br /> Owner's Addreas •� S�� 'Q��l`-!�t'��.�. O�iiner-Phone Number ,
<br /> Fee Slmple Tltleholder:.Name� � ' r��� "—� Owrner Phon'e Number '. _ ,
<br /> � , , , . . ,. ':'iF11� " ' .— ,� , , Fp . _ . . .. . ., .
<br /> Fe�Simple Tltleholder,Add,resa __ ��� °`�= = � -
<br /> JOB ADDRESS vC�� �\ , ,. � '� LOT# �
<br /> SUBDIVISION � 'P/4RCEL ID# � - " � `
<br /> � • , � >� { ' - -""(OBTAINEDFROMPROPERTYTAXNOTICE) - "
<br /> WORK PROP.OSED NEW CONSTR '' � ADD/ALT •[� SIGN ;Q "" �[]� DEMOUSH
<br /> . � -,� .e �• INSTAtL ;B ,�..: REPi41R� • _ •
<br /> PROPOSED�USE. Q� 'SFR [� COMM�, 0 OTHER ;' ' `. �
<br /> TYPE OF CONSTRUCTION.._ 'Q ' `BLOCK�', �Q__, FRAMEr � ,STEEL Q; • -
<br /> DE3CRIPTION OF WORK . :: "f �1`' C-q���� � '� _ ' � -
<br /> �,7� . .. _ � ' . '..,
<br /> BUILDING•SIZE' ; � � � . SQFOOT�►GE�� , . ,:HEIGHT..•. ,,. ` � . �
<br /> _., BUILDING $ �s�s�.:._ -r>:�,W,:,:r_.. � �l �8� � �
<br /> - - � VAWATION OF'TOTAL'CONSTRUCTION
<br /> QELECTRICAL $ ��`� - ,: : AMP SERVICE Q � PROGRESS ENERGY �], W.R.E.C.- .
<br /> V
<br /> QPLUMBING °$ ' �
<br /> .; . • � �;
<br /> OMECHANICAL '' $"�,' ' ` " VALUATION;OF MECHANICAL.INSTAI:WTION � �~�� ,/�
<br /> a�o�o - - _, . _ ,� .���- -
<br /> QGAS ,Q, _. ROOFING;::=Q SPECIALIY•'Q OTHER- "�<
<br /> � � �,;
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YE$. , NO
<br /> �.. - - ,-
<br /> BUILDER —_.._ .._._.__`-.. COIIAPANY ^`��� S�V��D. .... G����' .... .
<br /> SIGN�ITURE _,_...,-�-:-�--� REGISTERED Y/ N. ' �e cu�utEn: 'Y/.N.:;: , ..
<br /> Addre�s � � ' ' License# '
<br /> .= , �- ��J t J . � �
<br /> ELECTRICIAN�,:.. '�: �j�/, . � ,sy ''" COMPANY x` `���O� � ' . ;5 -
<br /> SIGNATURE -Gv"Y/ REGISTERED Y/ N FEE GURRE� '.Y/N :
<br /> Addresa � ' . - . ✓ . . , . _°L•fcense'#�� �
<br /> PLUMBER x ( _ . - COMPANY� ,: '
<br /> SIGNATURE ` � _ .�;REGIS7ERED= -:Y:/�tN , �FEE:CURRE��' 'Y/N.,=. �
<br /> �lddress :_ _ .. ; >. .Ucense#. -..n - � -
<br /> IWECHANICAI:, , , _ , `4 �.,,COMPANY_ c�� _ _ .. , , . ' - -
<br /> SIGNATURE ` ' REGI�57ERED' _ , ...Y;/`N-...' �',FEE.CURREt�= ' YIrN�•:��-
<br /> Addressz.. ,-, ''��Y� rN' . � ..e,. . _ . ' � ;ucense# �QLO �f.39�o. �:�- - - .I
<br /> �:, .. . �„
<br /> -,._
<br /> OTHER . -. - ., .r;, - -- - -�. '.'� ';C014APANY�� � . _, -' - ,- , ,. - h- - ... • . . ..
<br /> _ _ 4, . - _ . ..� :.`.(:� , i _. ..., , .� .. �. . c'; .. ."....a. . .,+
<br /> SYGNATURE% , � „ . "". _ �.REGis7EReo� :.Y:/�N:.: F��E'CUR�n-= :�YJ�N�-::., _ .. , . . -
<br /> Address '�.�}s.�;., -;,,: �:ts.�•ai{:.;r;: - �<;;,k,:::� .. ....,, =- � _ ,.. ;.. . � . ,_ . • .
<br /> License"#�
<br /> � — _ - - � �-;yi' .i.. ';,7r:, 'e�::=v:.,Y_ ��:.:�.� ..t�' i�A.4�`c.'i'4i;�;.'`tr.i:�._s.;'^u.�C;ir.., . ...._ _ . . ' .
<br /> RESIDENTIAL`., �:Attaoti 2'.P.,Id�P.,lans^�2�sets'�of;8uildi'n`"Rlans``..;1,�se't';of`Ene •Forrns��;R-0=1N;Pennit.forne�rconstructlon;,= - _ �
<br /> _,... :�?i _. ...� ),> _. ._. ��,). 9.... ,,�..),. r'9Y.. �..�:� -
<br /> �. ... . _ ,�. ., - <.�.�'2 .:.A :a: �._�}..� .� „p4!,t
<br /> <<Mlnimum;,tens(1;0.)�woritin_g;�ays,afteP,;submittail`ilafe:?�Requlteil:ons(fe;�Conslrucdon�Plans';tStoimwater'Plens:wl SIIt Fenqe.tnstalled, .
<br /> .., - ,�.. � .� �A.,.. .. . . .� .
<br /> � Sariltary Faclll��sn&,'�c�umpster,Site�WorK�Per�n�t�,r subdivi§lons%large'proJects::•,:�:.:;;�z.r•- �::� F��•. -= • � = �-' � , ° .
<br /> COMMIERCIAL Attach 3'eom lete=5ets oYBulltlfn''Plans�`�`lus a�Ufe Safe Pa e; 1 set of Ene Forms.R-O-W Pertnit for new construcUon.
<br /> � ) ,��� P 9 P b� 9 � ) r9Y
<br /> Minimum ten(10)woricing days after submittal date. Required onslte,.,Constructlon Plans,Stormwater Plans w/Slit Fence Installed;, , .
<br /> Sanitary Eadlitlas,8,l:dumpster...Stta.Work.Permlt;for-�Il�new;piojec#s:i411 commercial.requirements-must meet;complianca _
<br /> SIGN:.PERMIT AttacFi(2)sets of'Engineered?.Plans:�;�;�u'r�-�� ._ --. ` ,. � ,`? , " ' '
<br /> •••"PROPERI.Y._SURVEY.-�requlred..fqral,I:NEWaconstructloq.:: :;��:,v; � - , - •
<br /> Dlrectlon�• �4F-:=<:.;-.:;, , �� �._..., _. _. , _.. .��_. ,.. . �
<br /> FIII-out applicadon completely.
<br /> Ownar 8 Contractor sign back�of applfcaUon,notarized
<br /> If over�2500,:m Notice of,Commencement ts recpufred. (NC upgrades ov�r ST500), , 's., . '
<br /> �.f,.�;�,:�i,;<;:;,3.>:;;�•..._:•., ..�.w�.,.:,..._-.�..__.. . _.
<br /> '" Agent(for tFie contractqr)Cr:P`o�iiie�of Attoiney'�(for�lhe owner)would�be someone with nota�ized.letter from owner autho�izing same
<br /> D,.V,ER THE"COUNT.ER.PERiNiTTING-� -�=:'=(Fronf�.of�Applloation Oniy)�� �
<br /> Reroofs if shingles Sewers Servlce Upgrades A/C Fences(PI.otlSurvey/Footage) , .�- --_ - , - ,
<br /> _ . ...._. .. _.�..... _ . . . --... . _ �.:.. ,., � . _ -_ .�
<br /> . _. . _,. .,. . ,... _._..- , _. -- , _ :,., :, , ,..... ..
<br /> DNveways-Not over Counter if orr public roadwieys.:needs ROW, �
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