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813-7$Q-0020 Gity of Zephyrhi!!s Perrnit Application Fax 813•�aaoo2�
<br /> • Building Department
<br /> Date Received ��/�l Phone-Contact�for Permlttin� `' –
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<br /> -Owner's Nalme �� ' ` . Owner Phone Number � � „
<br /> awne�•s a�a�ss � �f ' OwnerPhone�Humber � ' , -�
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<br /> Fee 81mplelTltleholder'Name-� ) wner Phone Number �! :�� -
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<br /> Fee SimpleIT[deholdee,�Nddress � ' "
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<br /> �JOB�0.DDRESS � � L07# �
<br /> SUBp1ViSt�N PARCEL IC►#` •- , - -
<br /> j ' `(08TAINED`FRClM"PROPERlYT1UC'NdTiCEj
<br /> WQRK PROPQSEO : - '" �;NEW CONSTR ,�:, •'"' 11DDIALT' �� SIGN _ [� Q., DEMOLIBH ' ,
<br /> I � , .. � e . INS?Al:L 8=- RERAIR� ` "
<br /> PROPOSEQ�USE . Q� 'SFR Q . "COMM'' .[� OTHER " - .
<br /> TYPE OF CONS'fRUCTION.� � � `BLOCK�' FRAME, ---=5�'fE�- ...
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<br /> �DESCRIp'i'f�N`OF WORK h � '-f � � � � . _,-�
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<br /> Bt11LDlNG�SIZE� C�� �,3{1 FOOi'J�i1aE . , , .s _ � _ • � '
<br /> - ...� QBUILQlNG $ ..:�;:���::a. ,.m._,,�r:,_... ,. _ , .
<br /> � �,.-f •� VAlUATtOiV`�F"TO`TAL'CONS1`RCICTION , . . ,
<br /> [�ELECTRICAL $ AMP SER1lICE Q' PROC3FtE5S ENERGY 'a. �W.R.E.C., ,
<br /> [�P�UMBING $ ': ���� �
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<br /> [� ECHANICAL � �� Vi4WAl'ION:OE MECHANICAI,(NSTAI:LATIO � �'a�� �-{.G��J
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<br /> [�GAS [�. ROOFING;. �Q SP,ECIALTY' �,_ 'OTHER �` �""�� �f�
<br /> FINISHED�L,OOR EL.EVATIONS FLOOD ZONE AREA QYES. N
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<br /> CX BUILDER � . ` , � r� GQMPANY� �°��
<br /> SIGNATUl4E � ��` RECiISTERED Y/ N FEE CURRE�� ' , ` �Y/N-..
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<br /> �►ddrea$ . ' V . License#`�� ��'
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<br /> ELECTRlCU4N� =� , - GOi41PANY n - �
<br /> SIGNATURE �"' aeGlsr�aen Y l N �cu�E� Y!N . .
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<br /> Addre� � � �.Licerise#=;- -
<br /> PLUMBER . � COMP�ANY� �: . " • , . .' '
<br /> SIGNATURE ` ' - .��P , >REGIS.TERED= -.::Y/.�N • �:cuaR��' �`Y/N:-
<br /> A�3dnass y _ , license# - -
<br /> MECHANICAL: . ._ �. � , y, < .. . >,COMPANY,. . � , ..,.,,{ � _ - ' .
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<br /> SIGNATURE ' ~": ' ' . , REGI57ERED=- •:.Y;/�N.,. t.EEE CURRET � � Y-/-lV_:;", - '
<br /> A�ldre�� '4 - . '- ,. - � _ :•� _ . ,_ . . _ ' ,;License#.. ... ., .
<br /> OTHER � " , a:: ,.' .. ; - � . ; �,CO{yllPANY._ ` . ., � ., • , : __ , � ..
<br /> SIGNATURE . : p` ` ,. ' � _ ,I2EGISTERED ,,. X/ N:_� " -FE�CURI3E�� �Y•/,:N�.,.., • -
<br /> Addee� • ,.� ;�����,; '�,,�_�r. � f �. ;F:. �,.; :r4 . �,L'ic�rnse#��—' �" �
<br /> ,.':h�: ��'t�A'4:Ii,!''�:' i�i �',�a.i.f:��;f .a. . , . . ,... ' .
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<br /> RESIDENTI,AL;_ ^�AkCac�i.(2�;,Plok'Plans;�(2)�:s+ats':iaf;Build�iig Plans,(1)seti'ofrEne�gy�Fiirms;"R 0=W°Permlt:fot nevy.coristruettbn; _
<br /> i .:ystillinl.�um;,ten�� _.�,......;� :: ,..: .,� ,«, � ` - {
<br /> ,,. ,,,,,T µ„ (,1s0.�,workin_g;day;s:afler?`submlttal;dafe:�+Requlred.onslte;;�Ga'nstiucdon�Plans;tStortnwate�:Plans="vir/,SII#.Fence:installed,
<br /> �' ��SanEtai=yFacjli4tes&�;tac�umtPster,S14etWork;P,,+ar.mlt;�oc.stitidivl,'sionsliarge'projects:;:<.a:`s��"`�'� � ;~-- •' `.�_ � : ;�.` ,": ,
<br /> COMNlERCIi4L Attach(3)t'aomplete sets'of Bu`!l�itig`Plans plus a'Ufe Safety Page;(1}set of Energy Forms.RA W Permlt far new constructtan:
<br /> � Minimum ten(10)worlcing days after submNtal date. Requ6red onsite,,.Construcdon Plans,Stormwater Pians w!Silt Fence installed, , .,
<br /> � Sani�ry FaclliNes&:i,dump�ster.Site Work.Permlt•f4r alimew piri)e�:�All`obmmercial.requlrements must�meet`compliance ,
<br /> SlGM:PEFtMlT Attacti(2j"sets of"�ngliieeired%Ptaris;:;;�;:�r'�"�:.:; `-:_ „ , . , -
<br /> � "`"PRQPERI7.SURVEY.requlred-.fo�all:.NEW�consGvction.... _ _ � �- , • �
<br /> Dlrec!lonss � ..::��r.- . , . .. .._ . _. ,. .,., �_. ... . •
<br /> Flll out applicatlon wmpletely.
<br /> Ow+ner 8�Condactor sign back of appifcaUon,notadzed
<br /> 1f'over�2500�a:Notice af Cammancemani ta raqaired. {A/C up�rades ovar S7a00)._., . - . "
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<br /> '* Agent(far ttie coniractot}°or:Powei of�lttomey(fo`r='tlte:cvuner)�wrauld be someone with notadzed letter from awner authariztng same
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<br /> 'OVER�'THECt>UN.T.�R.FERIYliTTiNG�=`--:={Frcitt:of�ApP�tcationi3niyi}-.. _ ._. .;, , , w. .
<br /> Reruofs tf shi�ngles Sewers Servtce Upgredes NC Faqces.(PIoUSurveylFootage) -- - : _
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<br /> Drlvew�yra-Not aver Countar ff on�public roadw'ejis.:needs ROW
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