|
813aeo-oozo City of Zephyrhilis Permit Application Fax 813aso-oo2�
<br /> Building Department
<br /> Date Received ._ • . � :: .phon�Contact�for:Permlttin r'"' ' _' = , . ' � '
<br /> Owner's Name � � v /1/f/� � Owner.Phone Number ��� � �' ��b� '
<br /> Owner's Addrass ���(�� ' � !,/� OwnerPhone+-Number '�l� ��� �4✓�
<br /> Fee Slmple Titleholder Name� ' - ` ' �� �� � � � • " Owrner Pho`ne Nuinber , _ _
<br /> - , _ , _ , ...y = . � . ' .. . , . . ...
<br /> ,� . , . . .
<br /> Fee Simple Tltleholder.Address ;. • '''°�.�;: ��- � -•
<br /> JOB ADDRESS (,.�� �� �//vQ� (N�- �� L07# �r
<br /> SUBDIVISION - �r L(.``�� PARCEL ID# ���� Z.G-'Z �-�`'�D d���D Q�Y�-� �OQ�0 -
<br /> �� '.
<br /> . � � ,- ,` - ' - • " "_:�(OBTAINED FROM`PROPERTY TAX NOTICE) � '
<br /> WORK PROP_OSED' =�' NEW CONS7R -�'� '` ADD/ALT Q SIGN `Q` - Q'�"_ DE�MOLISH -
<br /> . , � B h. - INSTALL - .8;`.- REPAIR°. . � , - � - '' _
<br /> - . _ _. .. . . . ,
<br /> PROPOSED USE..� , "
<br /> Q�-- �SFR ` � _"COMM':: �:Q 'OTHER;�, `` ' =
<br /> TYPE OF CON3TFtUCT10N_� `Q � BLOCK�'�,�Q: � ,�FRAME � ;ST.EEG _ ._��;.'.,- • •
<br /> DESCRIPTION�OF WORK i j` 'e (e. l.� �f�. , - .
<br /> BUILDING�SIZE'� - �- SQ.F,OOTAGE, ,�, .�. -,, - �HEIGMT:\ -' � - �
<br /> --. . OBUILDING , $ -;��:s°�;;�..-.,., .,,�-:�_._ Y . .,
<br /> . . , VALUATION OF'TOTAG CONSTRUCTION
<br /> QELECTRICAL $ : � � AMP SERVICE Q' PROGRESS ENERGY [� W.R.E.C..
<br /> , .. � � :_
<br /> QPLUMBING : $ , . . . , - -
<br /> .i, . . . ' 8:: .; . ,
<br /> �AAECHANICAL ` $ �; ;VALUATION:OF..MECHANICAL INSTALL-ATION -
<br /> �� ��.. r ,
<br /> Q GAS :Q, � RQOFING..;��� $PECIALTY°Q� OTHER ��" � I
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �]YE$. , NO ,
<br /> . � •�. • ... _. . . •
<br /> BUILDER COMPANY� '"'°�,' :' . � � -
<br /> SIGId�1TURE REGISTERED Y/ N. " FEE CURRE�' �,,, .Y/_N-�;,_, , - ,
<br /> ' , .� - ` , - -- - v-�
<br /> Addre�s -. , _ � " "" ,�Ltcense# �� ' ` �
<br /> z�.- . ,
<br /> ELECTWCIAN.�--.�� . , • - � ` ` '� _., � , , . _,; � , . ' • ,. , .
<br /> M15
<br /> COMPANY 3�
<br /> SIGNATURE � _ `' REGISTERED Y/ N �e cuRtt�n '.Y/N .'�
<br /> - , , _ � , �. . . • .. . , � - _- o
<br /> Address - - - u . ; - �Ucen"se=#�`` � , _ ._ _, _
<br /> PLUflflBER ` ' - . COMPANYt: , .. „
<br /> SIGNA►TURE . �"� � - _ .
<br /> . _ ;REGISTERED: ! , ::;'Y/-.Nr � �,:-FEE�cuwt�' �.`X/'N.=
<br /> Addr�ss . ,:, - . : . >. _ �, .. • . -
<br /> ;. . ,;
<br /> .. ; - , `^ � ,_ ..License#+ -
<br /> nnecwaNic - '` ; �`'- .F� - . .�con�P�wir,-.- ;�r�v�, S�?;Se�;,�v�i4�'��✓���� ,.
<br /> SIGNATURE " '� � " _ _ _ REGt,�STERED Y _ - .;FEE.CURRE� , N�t �-
<br /> „ <
<br /> pldd '' '����`� =,.�V'G(.�' _�!�-�;- ���: ��y .,: - =s; _ �.-: � �. -� .r��1
<br /> resa�• _�� l�' �.� :License#: � �d'`T_ �.�
<br /> _
<br /> � : , . _ - - - ,
<br /> ��, . .. . _ ., ..T _ - .�" . . .. ' _ ! .i. .
<br /> O.T.HER , .,:4;a� . . . . , . - - :,COIIAPANY _ ' .,, ' _ .. , ,. , _ .,
<br /> ::� ..�r::r , , . - :;,. ,; .. : ... ... .... .._;;...' , ; .
<br /> SIGPII�TUItE.; . .. „__ ' � _,.,,.,REGISTERED-. _. , .Y/ N:- ;nEE�yCURF;E�'; :Y.:/.flL:=..�.,',:, , . �
<br /> F, _ ' r:i } r; .�.j.,- . _ � `:ti ' ' ._ .i.. ,. . . . .. ' .,.., . .. . ...
<br /> �►ddresa �C�r;: ."'a `-". '"•-- = - ` . � _ ' .l:icense#� � �
<br /> _ _ _ _ - _ - �ti ��s,. �t. ��.r_'=�_" '_ ..5.'["�:�K ;��,Fn r>:,n�� -.. . � — . . . ,
<br /> � RESIDENTIAL. =�=�AltacFi�2�Plof Plans�. se�'=of'Bulldln�'`y.lans•:�1 ��E '� "'. �
<br /> ,, � _ . , •.:-.:.� . -�
<br /> `� , � ts P ,sef;of. ne y'Fomi `R aW Peqr'ilt`for;new;oonshuption,
<br /> ..,.... �_•, ---.. , .( ).....; � :. ,(2) . ... . 9 (..),'_ �9 s�', , . .,, _ . .. :�-- " , :
<br /> -.."Mlnimumctens(19,rworifing�;days�aftet:sutimittsl'date:z;Requlied'ons(te;ConsUuctlon�Pians;.Stoimwate�'Plans w/"§IIt,FenCe installed,� -
<br /> �`i�; `Sanitary-FedllUes 8��1 dur�t�ster,Slte�WorkyPer,mit;for,sub'divlslon�Aarge proJects:�;i�:i��s,.,�':":---::.°'. : - -- -_ . �' _ -'
<br /> CONAIYiERC1AL Attech(3j�complete_sets of Bullding'Piens plus a Llfe Safeqr Pe'ge;(1)set of Energy For�s.R-O W Pertnit for neW constniatlon:
<br /> - Minimum ten(10)woricing days'after submittal date. Required onsite,,ConsWctlon Plans,Stortnwater Plans w/Silt Fence installed._ ,
<br /> Sanitary F�dtiNes_8,,1,dumRster.,.Site,Work.Pertnit,for all neuv`proj�ct's�NAll�commerdal:cequirements_must meet compliance
<br /> � SIGN.PERMIT AttacFi"(2)sets of"Engl�i'eered:Plen�;��;�:{�r ; _ . ,- : _ .. < ._ „ ,. ��
<br /> � .
<br /> ••••PROPERTYSURVEY:rgqulred;mfor�all;NEW:cons,tcuctlon:::_,�.�-�..:_.;_;- ' - - - ' - , -�
<br /> �Dlrecllons: . ,.�,::'�.= ,-_, _ � ..____ .._. _,�._. �- -- -- - .
<br /> _ F(Il:out appflcatlon completely.
<br /> �Ownar 8 Contractor sign back of appltcatlon,notarizad
<br /> If over'$2500,a.Notice„of.Commencement la r�qulre�. (AlC.upgrades over.57500),_ t•; .
<br /> �t.:<�•,.z�'i'�l�',s.r..,-, ..,.+:;:_...,_._....__ _
<br /> �.,�....,..�._.,.._....,. _ , .
<br /> 1f " -�.a .- .. ......
<br /> Agent(forttie contractor),Cr:Poiivq�'of Attortiey(fon fhe.ownec)would be someone;writh_notadzed-letter from owner authorizing same
<br /> ' '.OVERTHE�COUNTER•:P.ERMITIING:"':�`=:'(Front-ofApPlication`Only)�• -._ _. .��-,- _. ._.
<br /> Reroofs if shingles Sewers Service Upgrades A!C Fences(Piot/Surv_ey/Footage) . - -
<br /> , �._.,.,. . . . _ ..: r
<br /> .._. ,. ;�,,..:..u_�. ..:::- ..__ ... _ ... .:. :,- �.:.,.:�.,, � :i � . , _ . . - .
<br /> DNvewa Not over Counter if on� ublic roadwaµ� �� �C�
<br /> ys- P jrs..needs ROW
<br />
|