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a�saaa-oa2a City af Zephyrhiils Permit Application Fax 813-T8ti-0021 <br /> Building Depa�tment <br /> z • . <br /> Date Recelved `�� � - �0 �� phone Contact for Permittin �t� ���- KJ��� <br /> Owner's Name ` � �� l�����'�^� Owner Phone Nnmber <br /> Owner's Address 3 c� '�`' u�1 I��.�-1 1��� Owner Phone Number �—� <br /> Pee Simple Titiehalder.Name r— � Owner Phone Number �� � <br /> � <br /> Fee Simpie i'itleholder Address ' <br /> JOSAI�DRESS c���' ����-i��'� � i�G.�. LOT# � �"� <br /> SUBDIVISION � � PARGEL!D# <br /> (OBTAIN@D FROM PRQPERTY TAX NOTIGE� <br /> WORK PItOPOSED ' NEW CONSTR �ALT � SIGN CJ Q DEMOLISH <br /> � e INSTALL 8 REPAIR <br /> PRt}POSED;USE � SFR Q COMM Q OTHER <br /> TYPE OF CON3TRtlCTION � [� B�.00K ' Q FRAME � STEEL Q <br /> DESCRIPTIQN OF WORK �� ��" t,� � `�i 1 S <br /> BUILDING 51ZE �^� � SQ FOOTAGE�� HElGHT . <br /> [�]BUILDING ��Q� � VAI,UATION'OF T'OTA�CONSTRi1CTiON <br /> -�— <br /> QELECTRiCAL (�i� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> L <br /> QpLUMBiNG ($�� � <br /> �. �" <br /> [�]MECHANiCAL $ VALUATION OF MECHANICAL tNSTALLATION � <br /> QGAS Q R{30FING [� SPECiALTY � OTHER ��� � �� <br /> � <br /> FINISHED FLOOR ELEVATiONS FLOOD ZONE AREA QYES <br /> t <br /> BUtLDER _ � � COMpANI( �67z+� ���-�?r��. <br /> StGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address i:tcense# � � , <br /> ELECTRICIAN. COMPANY <br /> SfGNATURE ' REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre$s - l.icense# � �� <br /> PLUMBER C4MPANY <br /> SIGNAI'URE _______� ,REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ltcense# � �1 <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ 1V FEE CURREt� Y J N <br /> Address ' License# � � <br /> t3THER COMPANY <br /> S14NATURE REGISTEI2ED Y I �1 FEE GURRE� Y/N <br /> Address l.icense# r— �] <br /> RESIDENTIAt: Attach(2},Rlot Plans;(2}se#s of�Building`Plans;(1)set of EriengyForms;.R-O W Perrrilt far new canstruction, <br /> Minimurrt:ten�{10):wa�{ctng.days;afker.�subcTiSttal date. Required ansfte,Gonstivction Plans,Stormwater Pians w/Siit Fence installed, <br /> , Sanitary FaciliUes&:�.1 dumpste,r,Site Worii�Pecmit#or subdluistonsAarge proJects �� <br /> COMMBi2C1AL Attach(3)complete sefs`of Building Plans plus a Llfe Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new construction. <br /> Minlmum ten(40}working days'after submitfal date. Required onstte,Construc8on Plans,Stormwater Plans w/Silt Fence instaited, <br /> Sanitary Facilides&1 dumpster.Stte Work Permit far all new proyesits.All cammercia!requlrements must mest compllance <br /> SiGN PERMIT Attach'(2)sets of Engineered Flans.. �- ..�� <br /> *"'PROPERTY St1RVEY required for atl NEW cansfruotion. <br /> Dtrections: - <br /> Fi11 out appticatlon completety. <br /> (}wner 8�Contractor sign back of appllcatlon,notadzed <br /> If over$25Q0,a Notice of Commencement is required. (AIC upgrade�s over�750Q) <br /> "" Agent(for tFie�contractor)or Power.of Attomey(for tlie°owner)would be.someane wlth natarized I�atter fram owner authoriz4ng same M T <br /> DVER TME COUNTER PERMITTING � (Front of ApplicaUon O�ly). ' ' - � � � ' ' <br /> Reraofs if shingles Sewers 8ervice Upgrades A!C Fences'(Plaf/Survey/Footage) ' � � � " ` <br /> Driveways-Not over Caunter if on public roadways,.needs'ROW " �� � � <br />