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813.�so-oo2o Clty of Zephyrhllls Permlt AppllCation Fax 813-780-0021 <br /> .. � +. Buiiding Depariment <br /> Date Received �!(?— �j Phone_Contaat far Permittin �� �Jr` +1 � �� <br /> Owner's Name OV- �6 c� /� �. Owner Phane Number ;� �--�� t" '—'�QQ� <br /> Owner's Address �l� / � � � �P L►J �f .,i��Z Owner•Phone Number l,J�'-3�C �y��� � <br /> Fee Simple 7ltleholder Name � � Owner Phone Number �— —� <br /> Fee Simple Tltleholder Address �• <br /> JOB ADdRESS b � �7 S� � ) ` �l° ,� !'~� LOT# �_� <br /> SU801VISiON �� � PARCEL ID# � <br /> (OBTAINED FR4M PROPERTYTAX NOTICE) <br /> WORK PROPOSEQ = NEvtt CONSTR ADDtA4.T � SIGN [� Q pEMOI.ISH <br /> INSTALL e REPAIR <br /> PROPOSED USE [� SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION Q, BLOCK ' [^] FRAME � STEEL Q <br /> DESCRIPTtON OF WORK l�7`�lJ�e f�' �`'��,7 �� � ,� /5���-�i�C,�Lj f'�,� C���'�1�� <br /> + �� <br /> SUILDING S1ZE �� �� SQ FOOTAGE �� HEtGHT .^,_,,,, �� <br /> OBUILDING $ �.,,-�.T. -,,. .. - <br /> � �� VALUATtON OF TOTAL CONS'fRUCTION <br /> O � AMP SERItICE Q PROGRESS ENERGY Q W.R.E.C. I <br /> ElECTRICAL <br /> $ ...... .. <br /> QPLUMBING � � �/�'� �� `� ( <br /> -- -� l <br /> QMECHANtCAI $ VAlUAT10N OP MECHANtCAL INSTA�IAl'ION <br /> QGAS � ROOFING � SPECtA�TY � OTNER <br /> FINISHED FLOOR ELEVATIONS ��� FL.00D ZONE AREA QYES NO <br /> BUI�DER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Cicense# � � <br /> E�EC'FRtC1AN COMPAPtY <br /> SIGNATURE '" REGISTEREQ Y/ N FEE CURRE� Y/N <br /> Address -License# �— �� <br /> PLUMBER —y� �pMpp�y <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre�s License# �� � � <br /> MECHRNIGAL CdNIPANY <br /> SIGNATURE REGIS7ERED Y,/ N FEE CURRE� Y/N- <br /> ��d�g License# �� �� <br /> QTNER �G�Z�� CQMPANY ����� �SQ� � C(� ' �,,.�C• <br /> SIGNATtIRE �b REGI3TEREU Y/ N . FEE CURRE� ; Y•%N: <br /> Address ��I l���-`'' �' ,��J2���/�,.J ,� license# � '�,�3.Zc.�c�! � ' <br /> RESIDENTIAi. Attach(2)P,lot Plans;.(Z}sets:of:Btitlding Plans;{4)set af Energy�Farms;R O-W Pemiit for new,construetion, <br /> Minimum ten(•10),working,days�after"submittal dafe.�Recjulred onsite,Construc�on Plans;�Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliUes&,.1-,dumpster,Site War4c Rermit for subdivisionsAarge projects �;� � <br /> COMMERCIAL Attacfi(3)cosnptete sets of BeiiidEtig'Plarts plus a Life Safeiy Page;{1}set af Energy Fotms.R-Q-W Perrnit for new construcf�an. <br /> � Mlnimum ten(10)working days after submlttal date. Required onsite,Canstructlan Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles 8�1 dumpster.Site Wark Permft for all new proJebts:All commercial.requlrements must meet compliance <br /> St6N PER�IPIT Attacti'(2)sets of Englrieered Plans.,�t „ . - <br /> ""PROPERTY SUR1%EY required for.all NEW constructian. <br /> Dlrections: � <br /> RIII out applicatlon completely. <br /> Owner&Conkraotor slgn back of appllcadon,natarized <br /> If over�2fi00,a Ptotice of Cammenaement is required. {AtC upgra;des ovar�75dQj � <br /> " Agent(for the cbntractor)or Power of Attomey(fo�tFie owner)would be someone with notarized letter from owner authorizing same <br /> dVER TME COUNTER PERMITTING {Front of Applica#tan On1y} <br /> Reroofs if shingles Sewers - Service Upgrades A/C Fences(PIoUSurvey/Foatage) <br /> Driveways-Nat over Counter if on public roadwa}i's..needs ROW��� <br />