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8�saao-oozo City of Zephyrhi!!s Permit Application Fax 813-780-Q021 <br /> Building Department <br /> pate Received p�yQ�$.�,�n��ffor Permitttng - � � — ��d�' � <br /> Owner's Name � 1'/ C!/'!`1 S dwner Phone Number � <br /> Owner's Addrass Q�p^ ��` bwnerPhone Number � � <br /> Fee Simple T4tleholcler Name � r�✓[ � � Owner Phane Number � � <br /> � <br /> Fe�Sfmple Tttleholdar Addrsss ' <br /> JOB ADDRESS CJ� 7�` LOT# C_�.� <br /> SUBDIVISION � � PARCEL ID# <br /> (OSTAINED FROM PRdPERTY TA7(NOTIQE) <br /> WdRK PROFOSED ' NEW CONS7R ADD/ALT � S1GN Q Q DEMOLISH <br /> e INSTAL� 8 REPAfR <br /> PROPQSED USE [� SFR Q GOMM Q {?THER <br /> TYPE OF CONSTRUCTfON Q BLOClC ' � FRA{UIE � STEE� � <br /> pESCRIPTION OF WORK j�"'' Y r Gf'c'�{�.A. <br /> BUILDING SiZE ��� SQ FOOTAGE[� MEIGHT �.,�� <br /> QBUILDING $ �� D� VALUA710N OF�TOTAL CONSTRUCTION <br /> . <br /> �]El,ECTRIGAI. $ AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C. <br /> OPLUMBING -(— ^ , j'_ ����j . <br /> ��_ ���l <br /> Q MECHANlCAL $ VALUATlON QF fVIEGHANICAI.lNSTAILATiON <br /> QGAS Q RQOFlNG Q SPECIALTY � QTNER <br /> FWlSliED FLQQR ELEVATlONS � � FLOQD ZC?NE AREA QYES. NO <br /> BUI�DER COMPANY � / <br /> SIGNA7URE RE�Est�a Y/ N FEE GURRER )�! <br /> Address �i U � License# (,'I ,�'�•� 5} �'/� <br /> ���cr�c�� con�PAratr <br /> SlGNATURE �' REGISTEREd Y 1 N FEE CUI2RER Y 1 N <br /> Addresa License# � � <br /> PLUMBER Ct}MPANY <br /> SIGNATURE REGlSTERED Y/ N FEE GURREh Y t N <br /> Address License# � �� <br /> MECHAN3CAL C{,}MPANY <br /> SIGNATURE REGISTEREd . Y:/ N FEE CURRER Y t'N <br /> Address� Lloense# I � <br /> O'iHER COMPAt�tY <br /> SIGNATURE REGISTERED Y/ N FEECURREt� , Y.t.N. <br /> Address " � � Llcense# i I <br /> RESIDENTIAL ~Attaoti"{2).Flcit Plans;.(2)sets.oF Buitding Fians;{1)'set of Energy°Faims;R-O-W Pern%It for new constructian, <br /> Mlnimum,ten(10)working'days:after.submittal date.�Requlied onsite,Constiuction-Plans;�Stam+water`Plans w!S(It Fence instaUed, <br /> � Sanitary FacitiUes&��1.;dumpster_Site Work.Permit for subdivisions/large projects :_ � � <br /> COMMERCtAL Attach(8}cbmplete sets of Bullitirig Pians ptus a l.ife Safety Page;{1)set of Energy Forms.R-O-W PeRnit for nsw c�nstru�on. <br /> Minimum ten{10)working days'after submtttal date. Required onsita,ConstrucUon Plans,Stomswater.Plans w/5ilt Fenae lnstafled, <br /> Sanitary Facili8es&1 dumpster._Site,Work,P_ermit for all_new projects:All t;ommercial requlrements must�meef compliance <br /> SIGN PERNIIT Attacti"(2}sets of'EngfneeredzPians.; , � - � <br /> ""PROPERTY SURVEY reguired for al!NEW,construcUon._ <br /> Dltectlans: <br /> FlII out appltcallon complstely. <br /> Owner&Contractor sign back of applfcaUo�,notarized <br /> if over 52500,a Notice of Commencoment is requtred. (A!C upgrades over�7500) <br /> '* Agent(for the cantracto�r}or.Povrier of Attomey(for the awnerj would be someone with notarized letter from owner authorizing same <br /> DVER tHE COUNTER.PERMITTING (Front of Application Oniy) <br /> Reraofs If shingtes Sewers Seroice Upgrades AtG Fences{PtaUSurveylFootage) <br /> � Driveweys-Not over Gaunter if on public roadways..needs RQW <br /> � <br />