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813-780-0020 City of Zephyrhitls Permit Application Fax 813-780-0021
<br /> Building Departrnent-� .. ...,.._, _ , _
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<br /> Date Recelved P � - � ` •� - , `
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<br /> Phone.Contactfor Permlttin �• �� — a'
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<br /> Owner's Name l Cu� �- Owner Phone Number``•^ =�-••��::��.:,.._�,. �•
<br /> Owner's Address r„2 Owner Phone'Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simpla Titl�holder Addresa � -
<br /> JOB ADDRESS LOT# �
<br /> SUBDIVISION � PARCEL-ID# � - � �
<br /> - , (OBTAINED FROM PROPERTY TAX NOTICE) .
<br /> WORK PROPOSED , NEW CONSTR ADD/ALT Q SIGN� Q Q DEMOLISH
<br /> �e. INSTALL e • REPAIR
<br /> PROPOSED,USE,_ Q SFR Q COMM Q OTHER �
<br /> TYPE OF CON3TRUCTION '-, Q �' BLOCK " 'Q FRAME Q STEEL Q
<br /> DESCRI PTION OF WORK' �v,� � v CG � O����''�^ �� �r2.��r�/ � G�
<br /> BUILDING SIZE - �' SQ FOOTAGE� HEIGHT
<br /> QBUILDING $ ` , � � ` ��-.•- .. .
<br /> , VALUATION'OF'TOTAL COIVSTRUCTION
<br /> ELECTRIGAL $ � � AMP SERVICE,�� •:Q�ROGRESS ENERGY Q_ W.R.E.C.
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<br /> QPLUMBING `$
<br /> Q MECHANICAL $ VALUATION OF;MECHANICAL INSTALLATION . �' l����
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<br /> QGAS Q ROOFING Q SPECIALTY, Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY' �
<br /> SIGNATURE REGISTERED Y/ N Fee CURrtEn Y/N
<br /> Addres� � - Llcense#
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<br /> ELECTRICIAN, 'COMPANY � r 40��J'�j � C��c G
<br /> SIGNATURE REGISTERED Y/ N �e.cu�n'� �Y/N
<br /> Addreas ( �� -f f• Llcense.#., : �C-''. C��'7 2j�
<br /> PLUMBER �_ COMPANY • :,. • �
<br /> SIGNATURE ' ' „ ,REGISTERED Y./..N�(� - FEE CURREA : '� Y—/N. :_:
<br /> Address - Ircense# � _ •
<br /> MECHANICAL � COMPANY
<br /> SI(iNAYURE� `•' ' ' " � ` REGISTERED Y./ N ', FEE CURREP Y,/�N
<br /> Addre�s ' = � " - ` License#
<br /> OTHER " � COMPANY
<br /> SIGNATURE � • � � ' ` 'REGISTERED Y/ N . Fee cuR�� Y/N.
<br /> Address ' � License#
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<br /> RESIDENTIAL,.� •Attach'(2),Plot�Plans;:(2)sefs:of<Buflding�Plans;(1)sef of-�Energy�Fo'r'm's;�R-0=W PeRrilt for new construcUon,
<br /> . ,, Minimum;tem(:1,0)�working;days after;;submittal"date.':Required onsife;;Construcdon=Plans;�Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Fadlfyes-&�,1.dumpster,Site.Worlc.Pertnit tor subdiVisionsAarge projects, _,� ` -
<br /> COMMERCIAL Attach(3)�complete sefs`of BuiliJing Plans plus a�I:ife Safety Page;(1)set of Energy Forms.R O-W Permit for new constructlon.
<br /> Minimum ten(10)worlcing days after submlttal date. Required onsite,ConstrucUon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles 8 1 dumpster.Site Work Permit for ali new proJects:All commercial requlrements.must meet compllance
<br /> SIGN PERMIT AttacFi(2)�sefs of Eng,i`neer,edcP:.lans.,,•-����-- �� .� �
<br /> ""PROPERTY SURVEY required for all_NEW.construcUon.
<br /> Directlons: • . '
<br /> FIII out applicatlon completely.
<br /> Owner 8 Contractor sign back of applicatlon,nota�ized
<br /> If over 52500,a Notice of Commencement is requlred. (AIC upgrades over 57500)
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<br /> " Agent(for the contractor)or Power of Attomey(for tFie owner)would be someone with notarized letter from owner authorizing same
<br /> DVER THE COUNTER.PERMITTING - �(Front of-Application Only)- -
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drivewaya-Not over Counter if on public roadways:.needs ROW ' �
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