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81$-790-0�30 City of Zephyrhilis Permit Application Fax 813-780-0021
<br /> Building Departrnent
<br /> Date Rece�ived . � • �j p �^ - I
<br /> i . . . ;-Phone-Contact<for�Permtttin ��" '• .Dl� O � — ...!��� ..
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<br /> Owaer'a Name �S/14(�/� � R' �� � . Owrner Phone Number O l�" //D "(OSP�
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<br /> Owner's Addres� �� /�G Owrner•Phon��Numtier ` ' � i ��
<br /> Fee Simpli Tltleholder;Name°� � � ' � � Owner Phone•Nuinber '" I
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<br /> Fee S(mpla Titlaholiler Address �=Zj�:�,� � . ��
<br /> JOB ADDI2ESS � � �/ �� � , LOT# _ � I ,
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<br /> SUBDIVISbON � ,PARCEL";'ID# �T,,. ��':`�%,�,..����' .��;`o�OTC�' I
<br /> ' . , � � ' .-�(OBTAINED FROM PROPERTYTAX�NOTICE); � �
<br /> WORK PROP.OSED � NEW CONSTR "� . ADD/ALT =[� SIGN �Q;" ��-� �, Q J"' ,;�DEMOLISH - � ,
<br /> .. , • ��B `• � INSTALL .�:REP�►IR E' � �
<br /> PROPOSE�-USE� ,., •Q:; =SFR. � � ; �COMM�`* ;Q 'OTHER' ' � '. I
<br /> TYPE OF CON3T1tUCT10N; �'Q v BLOCK�' `Q'., ,FRAAAE . [� STEEL. Q _ - - • { .
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<br /> DESCRIPTION 0F WORK �� ��GS � C !
<br /> .,= C�i/�-N ����e-� �oitl . � � o c
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<br /> BUILDIFIG SIZE�' � SQ;FO.OTAGE ..� . - . -� � .nHE1GHT��,� .. ;: - � '
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<br /> QI UILDING _$ _. µ����:.v. ...�.,r.. . . ; _.. ,. • �� ' - i
<br /> � - , • .VACUATION`a�`TOTAL'CON§TRUCTION , 1 '
<br /> QELECTRICAL $ AMP SERVICE �, �Q' PROGRESS ENERGY [7_ � '�W.R.E.C.; ',
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<br /> QPLUMBING •$' ~. �
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<br /> [� ECHANICAL ' $ y -VALUATION;OF MECHANICAL.INSTALLATION ?j�� �� I
<br /> i �99�'0 l�t?.. . . -
<br /> Oc�►s [� - ROOFING:,_Q seEci�nr:0 OTHER� ��� �
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<br /> FINISHED', LOOR EI.EVATIONS FLOOD ZONE AREA , QYES. NO �
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<br /> BUILDER COMPANY � � �
<br /> SIGN�►TU E REGISTERED . Y/ N. `FEE CURRE�";,_ Y/.N. _-S_. , I ,
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<br /> AdelfeSs ''�, "' . . LlcenSe#` " ` . �
<br /> ELECTRICIARI�. Y - � � +COMPANY' � ' -: - -
<br /> SIGNATUR - 1 sry ' REGISTERED Y/ N FEE 6URRE� Y/N ' � I
<br /> Addre � "'_ ` ., _,. .. � , �.Gcense:#� • ` . , �
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<br /> PLUfHBERi - � • � - .CAMPANY:;. .;`.,,. .. : .- �
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<br /> SIGNATUR ` - � <REGIS7ERED;- ,. '�Y'/�.N � ��.cut�En �. �'Y/N,' I
<br /> �0.ddres� � , �. .,.. 4� ' , L-icense# - . , .. i
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<br /> NaECFiANICAL�s�� - � . ,.COMPANY. .�I.�R S. ��f�-/�/�?�..!,..'%.C:.�/!/C � ,
<br /> SIGNATURE " , REGISTERED` ' .Y:/ N': , �FEE:CURREP _ Y,/�M�' �
<br /> Addre s: ' ��� flEN �i '�'/�/LL.S�. , , • License#. �'!4-�d ��l�c� � . i
<br /> OTHER � � _ .:_ . ,. . ,�. ,. - - f CONIPANY: ..-. -- � , , - . .
<br /> SIGPiA'PU I ;� •, . ,'. _ . . _�. .. ' YREGISTERED , ''YL,N._a.'� FE�".G,URBE�� Y:1,N�. , .
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<br /> AddPe _ ::t _ �License'#• �
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<br /> RESIDENTIAL:;�-�`-AttaoFi;(2;;P1gt;Plans;t 2:sets�of;Bulldin''PI_ans;";1�;set:of.°Ene �Forms��R=O=W�Permit:fof.new;constructfon: - , � ,
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<br /> ;�:-r,Mlnimumr.tenw(1�0);worlting;d.'a.ys�;after,�'s"utiinittal tlatie,...Required onsite;-�onsUucdori;Plans;cStormwater;Plans-w/,-�Sllt FenC,e installed,, .
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<br /> � Sanitary Fac�ltdes&�,��cjuqtpst�r,S14e�Work��Penri�pt���r subdivisio�s%la�ge projects',:�':x:,-d;:•,, �y- ,.- -�" '�' -::.-_ :_ � .__ �
<br />- CaAAMERCYF►L Attach(3j eomple4e�sets'of Bull$ing'Plans plus a Life Safety�Page;(9)set of Energy Forms.R-O-W Permit for new ccnstructlon: - - -�
<br /> Minimum ten(10)wrorktng days after submittal date. Required onsite,,ConsUucUon Plans,Stormwater Plans w/Sllt Fence Instailed;. ;
<br /> SaMhary,Facil(tles.,�,1_dumRster..Site.Work Permit tor all'new,projects:;All commercial:requlrements•mustmeet compllance
<br /> SIGN:PE .�IT Attacii`(2)sets of Eagi�eered�Pla�s 4 . r � . _ . . , � ' -
<br /> "••PROPERTY SURVEY required fa�aII,NEW coqshuctloq . " .: , �
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<br /> �Dicectlons: �:�;'::��;��_;_.,. . _. ._ _. - _. .. .
<br /> Ffll ou4�ppNcallon oompletely.
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<br /> Owner&Contractcr,sign bacic�of applfcaUon,notarized
<br /> If'over 52500,.a Notice of:Commencement is requlred. (A[C upgrades oyer$7500) _ ,_ . � .
<br /> �w I 'C:�:;;"t;�,h�+.,�:��{�.;,„ _.. . -•...:.._...._.._. ,_._ ..... -.,__-.._ , . . .. . ._. : , �
<br /> Agent(for ttie conVactot):'Or=PoweF'of'Attortiey(forftie�owner)would be someone.with notarized letter from owner authorizing same ;
<br /> `01/,ER THE COUNTER;PERMITTING:-..-.":.:=(Front'of�ApPlication Only)=� �- '''-�•�'�.�, ^ �
<br /> Reroofs if shingles Seweis _ �Service'Upg�ades,NC ; Fences:(Plot/Survey/Footage) .., --- .�. - '
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<br /> Driveways-Not over'Counter if on public roadways.':needs�ROW � r �^ �-�" �f - ._,
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