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813-780-0020 City of Zephyrhilis Permit App(ication Fax-813-780-0021 <br /> . � Building Department <br /> Date Received �— j„}�-^ �� phone Contact for Permitting -- <br /> Owner's Name C.�`R LL. �J�,�'�� Y.ZG.' f� ..�+�� Owner Phone Numbet <br /> Qwner`s Address ) wLf�Q 7p -d-L--3.3"S Owner Fhone Number �! � <br /> Fee Simple Titleholder Name �! � Owner Phone Number �� � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS (G� � �* ui y4�/�1�//�" cGL� ` S` L4T# � <br /> SUBDiVtS10N �� � PARCEL td# <br /> {QBTA[NED FROM PROPERTY TAX NOTtCE) <br /> WQRK PROPOSED e NEW CQNSTR 8 ADDlALT � SlGN C] 0 DEMO�ISH <br /> INSTALL REPAIR <br /> PROPOSED USE 0 SFR Q COMM C� OTNER <br /> TYPE OF CONSTRUCTION 0 BLOCK Q FRAME C� STEEL � <br /> DESCRIPTION OF WORK D � �� 5���-� <br /> BUiLDING SIZE � � SQ FOOTAGE�� HEIGHT �_—� <br /> �BU��DlNG IS��/'� VALUATION OF TOTAL CONSTRUCTIQN <br /> L � <br /> �ELECTE2ICRL r$ ,,/�_,.� � Afv1P SERVICE � PROGRESS ENERGY Q W.Ft.E.G. <br /> ///�f <br /> [�PLUMBWG �! $ /� .1- �1 � <br /> !o ��� �J� <br /> OMECHANlCAL $ VALUATlON OF MECNANlCAL 1NSTALLATIal� <br /> ��,,�'" <br /> OGAS ROOFlNG Q SPECIALTY � �THER C <br /> FINlSHEQ FLOOR E�EVATIONS r�� FLOCJD ZQNE AREA DYES Rt0 <br /> L <br /> BUtIDER COMPAPtY <br /> SIGHATURE REGISTERED Y/ N FEE CURREA Y 1 N <br /> Address License# �i � <br /> E�ECTRIGIAM CdMPANY <br /> SlGIVATURE Re�iSTEa Y 1 N FEE cURRE� Y 1 N <br /> Address License# � i� <br /> . <br /> PLUMBER C ANY �f~ -C 2�.-J�hrJrc£5 �,1�G� « <br /> SlGNATURE � REGIS7ERE4 Y/ N FE&CURREt� Y 1 N <br /> Address License# C..-t-C i�,�'�`�' �� <br /> MECHANIGAL COMPANY <br /> SIGt�A7URE REGfSTERED Y! N FEE GURREP Y J N <br /> Address License# � '� <br /> OTHER � � COMPANY <br /> SIGNATURE f2EGISTERED Y! N FEE GURRES� Y J IV <br /> Address License# � �� <br /> REStDE1dT1At. Attach{2}Piat Pians;(2}sets of Buiiding Pians;('f)set of Energy Forms;R-O-W Permit for new cansfruction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,Skormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> GOMMERCIAL Attach{2}complete sets of Building Pians pius a Life Safety Page;{1}set of Energy Forms.R-Q-W Permit for new construction. � <br /> Minimum ten(10)working days after submittal date. Required onsite,Ganstruction Pians,Starmwater Ptans wi Siit Fence instalied, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGA!FERMtT Attach(2)sefs of Engineered Plans. <br /> ***'PROPERTY SURVEY required for ail NEW canstructian. <br /> � Directions: ` <br /> � �il1 out application eompfetely. <br /> Owner&Contractor sign back of appfication,notarized <br /> � if over$250Q a Notice of Commencement is required. (,A/C upgrades over$7500) <br /> *' Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A!C Fences{PIotlSurvey/Foo#age} <br /> Driveways-Not over Counter if on public roadways..needs ROW ' <br />