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a��aap-aa2o Ci of Ze h hills F"ermlt A lication Fax 813-780-0021
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<br /> Building Dapartmen#
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<br /> ' I _ � �Rhone=Contact'for_Permittin'�`:':�
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<br /> Owner'�Na f e , �"� j,� � � L..�.{�. Owner.Phona Humber T��– ��
<br /> Owner'�Ad ress �+/'V 1Q11J�'(`S t�j� �l� ST�D(U Cv t�wner•Phone Number �'' " ' �
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<br /> Fea Simple� Itleholder�Name��� � ' �` .� Ownar Phone Num�er ' - �
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<br /> Feo Simple ,tleholrler,Address .. �' � ., � , . �
<br /> JOB ADDR SS ^ t•J SJ`T � � � �l� + ���� ��T� .. , . LOT# �� .
<br /> SUBDIVISI N � „ ' PARCEL ID# ' ` j "" � ` �� � !,�'C/�.� .4.KJ�� G%�
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<br /> '(OBTAINED'FRC111l�PROPERTYtAXN4TiCE)' }r
<br /> WOttK PRO�POSED :" "� • NEW CONSTR �. �" ADD/ALT �� �StGN [� y 'Q`" � DEMOLISH � � - , ,.
<br /> , 'e INSTALC ,�`":REPAIR - -
<br /> PROPOSE :USE 0=` SFR �] "COMM`` � OTHER' -:' ° , _ .
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<br /> TYPB OF C N3TRUCTION;� Q -�BCOCK '^`�] FRAME � �STEEL. [�]�-�: , - -
<br /> DESCRIPTI W OF 1NORK :.?�' ^`� ' ., , " .
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<br /> �UIL,DING°$IZE.� �.�SQ,FG1QtAGE; � . . �,vHE _ � . - . �
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<br /> ., OB� tLDiNG $ -��.:�:;;,�:�. _...»-r.��...; n::
<br /> :V�1L.CIATION''�F`rOTAL'CONSI'Rt1CTION
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<br /> QE ECTRIC�4L ($ :_ �� RMP SERVIGE- �Q PROGRESS ENERGY [�?� .W.R.E.C..
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<br /> [�P UMBING � $ _ , . .
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<br /> Q ECFiPtNIGAI + $ �,�o�D,v DI}: �VAI.lJAT'IQN;OF MEGFfANlCAL;ENSTALLATlON ',r
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<br /> FINISHED ,LOOR ELEVATIONS ��-� FLOOp ZONE AREA �]YES. NO .
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<br /> BUILDER COMPANY ''' , , - � � -
<br /> SIQ�IATUf� REGISTERED Y/ N. ' �e CuwtEK: `R.. '.Y/_N,_.:;.,i:
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<br /> �_ :�. ., COHfPANY� �`'
<br /> SIG�IATUR M REGISTERED Y/ N FEE 6URREN ' '`Y'%N' ..'
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<br /> PLUMBER� � _ , CO,MP.ANY,,; , „ �� '
<br /> SIGNATUR ,� R,�G�s�RED „ �::Y~/�N�- {.'.:•FEE�CurtREn�x , 'Y/�N:_ .
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<br /> /:'N,.a. FF,E CURRE� :Y hNa::;.
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<br /> ESID tta „.(2);,FI.t.Pians,h(2);sets�afiBw,dngA s��( )setqf nengyF rms, . t�-,,_,,..,, it.._y....,.. .. � � : _
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<br /> � ' ,Minii�ium�.ten�i1Q'wiorkin�<d'a �afte%�sutimiftalydate�*+R`�uired on'sifB;�Co"nstr►ic8on?Plans;_Stor`mwater Plans�wl-Sllt Fence.fnstalled, ,
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<br /> Sanita:.��Ea 4i� �8��1'c1u e'`�Slte oik'Peri�rit'�`r.sutidivlsiti "e�Atoects:`�r;�„`�`���;:4��`. . _ ,� -, _ ._
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<br /> "' -CONIMER I,AL Attach(3j=eoinplete'`sets'of Bulldi'ng Plans plus a�ttfe Safety Page;(1 j set of Energy Fartns.R-O-V1l Permit for new construc#icn:
<br /> Mlinimum ten(10)working days'after submittal date.-Required onsite,,ConsUucBon Plans,Stormwater Plans w/Silt Fence Installed;,. -,
<br /> Sanitary Fadlitles.&.1_dumpster.,.Site.Work,Per;nit.for;at!new�pro��ct's:`Ail'cammerc�ai.:requlremenis�must'meet compilancs � . , ..:
<br /> StGM PE IT Attacti(2)sets ofiEngi�ieered.;P(a�s:�:;�:w��=;;:.;::�:�'':� `��`..-3� ; _ . ' .; . - - = ,F.
<br /> «•••PROPERT'Y SURVEY reguired•for�ll NEW-cons.tructlo, " = _ , , � . � , ,
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<br /> �Dir;eictlons: i�;Y�.a:.9: , _ ,� ._._. . . _ .. _. . . .
<br /> FIII'ou appllcaUan completely.
<br /> flwne &Contractar slgn:back.of appltcation,notarized '
<br /> Ifiove �6250Q,,��.Notir:q of:Cor�nmencement is requiresi. (AIC.upgrades ovee i7500)_.. „ �t _
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<br /> " Agent��{for th�conttactot}pr�Aower cf Attomey(foi'!!ie owtieiy wautd be someone.with,nataiFzed tetter from owner autho�izing same
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<br /> :DVER'TH��COUNT�R:P�RMITI'IN��=•--•�":{Front:ofApplic:s�tion l�nly)���
<br /> Reroofs If shingles Sewers Service Upgredas i4/C w,Fence�s.(Plot/5urvey/Footage) _. _.- - __ .. _. _.. .. ._.
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<br /> DHve ays-Not over Counter if on`pwblic r+nadwejis.`:ri�eeds RQW,, .
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