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- 813-7 0-OD20 City of Zephyrhiils Permit App{ication Fax=813-78Q-0021
<br /> - Buitding Department _
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<br /> Dat�Received • . Phone Contact for P�rmitfieig "' -
<br /> Owner's idame V��` `t°,.� Ownec l�hone Number , _„_,�,
<br /> Ownec"s<Addr ss. ��� � Owner Phone Plumber � �
<br /> Fee Simple Tit eholder�m? Owner Phone Numb�r �— �
<br /> Fee Simple Ti eholder Ad
<br /> JOB�4DDRES - L �~ �QT# ��
<br /> susotv�sio� � � ��c���Q� l �_Z.(�-- Z ''bb t d--b 1 qao �a d�C7
<br /> . � . (OBTAItdED FROM PROPERTY TAX NOTICE)
<br /> VVQRK PROP SED . New coNs�R �ADD/ALT � SIGN Q` [� DEMOLISH
<br /> , e INSTALI. 8 REPAiR
<br /> � PROP.OSED SE.. Q SFR Q COMM � OTHER''.
<br /> ; TYPE OF CO STRUCTIpN � BLOCK - [� FRAME � S,TEEL Q
<br /> DESCRiPTlO QF WORK �`�t:�(.�} `�j`,�1�' - �� ! .� � � � ��15 T!4� . (�(f �
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<br /> � �� � SQ FQQTAGE �� . NEt!'sMT L `�..r� �� ' �i�� �S
<br /> Bui�oi��s� e
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<br /> �BUI DING � ^� �C�,C` VA�UATION°OF'TOTAL GONSTRUCTlON �"�,j�,����
<br /> .+�✓ �
<br /> .�,�EL C.T,BICAL ,($ �� AMP SERVICE �� PROGRESS ENERGY "Q W.R.E.C.
<br /> �_
<br /> QPL�MBING � �
<br /> �JME HANICAL $ VALUATION OF MECHANICAL.iNSTALLATION Z�f' l� t ��
<br /> OGA � ROOFING Q SPEGtALTY � OTHER
<br /> FINlSHED.F OOR ELEVATIONB FLOOD ZONE AREA QYES N�
<br /> BUILDER ! Y i� -r��}�y C4MP�tdY " ���'�- Q�'����'j��! y
<br /> SIGWATURE ���`� ���r i� `'�✓ ��' .�REGISTERED Y/`N FEE GURRE� Y/N
<br /> ,�ddres � l.icense#`�i �
<br /> EI.EGTRICI ' COflAPAPIY
<br /> SIGPIATURE " REGISTERED Y/ N FEE CURRE� Y/N.
<br /> �.'- ' ,p
<br /> Addres License.# � �
<br /> PLUl4�BE�_: . COMPANY� � .
<br /> -SIGNATURE �REGISTERED� , 'Y�/�N . �FEE GURRE� Y/N
<br /> , Addres License#`�� - ��
<br /> MEC�Ii4NiG COMPl�NY
<br /> �� 31GNATUR ` - ReGIST�REQ Y/,,N , F.EE CURRE� Y/�N
<br /> �idd'res � � License# r----r—�
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<br /> _-_QTNER� k.^ , . ' ' - ' CONA PANX : � �
<br /> '$IGNATWR '.. ' ' • ' REGISTERED Y I N . FEE CURRE� Y,I N
<br /> Address:<. _. . - . � � L'scense# �—.—.—.— �
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<br /> ' �RE$IDEPOT4 ��.; Attacli::{2)<Plot°P.lans;:'.(2),sets�of Building:Plans;(1)set of'Eneigy:Forms;`R=.O-W Permit for.new,con'struction,
<br /> � �-�;;_�: . - �~ 4;�Mini.mum`,:ten;_(1'U)working�days after;su6mittal�date. Required�onsite;=Con"struction Plans,Stormwater`Ptans vu!Silt Fence_ins#atted,
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<br /> Sanitary,,Facilities�&1;�,dumpsfer;Si#e; ,W.ork=Pecmit'for.sutidivisions/iarge��prbjects:`> � '
<br /> ; . � . .,..�.__ ._ .
<br /> __:::.GOM�IEitCt Attach�(2}coinpiete:sets of'Builiiing Pians plus a Life 8afety Page;{1 j set af Energy Forms.R-Q-W Permlt for new construcHan. . .
<br /> Minimum ten{10)warking days after submittal date. Required'onsite,Construction Plans,Stormwater Plans w/Silt Fence.installed,
<br /> ° Sanitary Facilittes&1 dumpster,Site,.Work.Permitfo�-ati new projects.All commerciai requirementsmust meet comptiance
<br /> ,�,�$i.Gld`P�R IT �A#facfi`(2)sets ot:Engineer�i!P1ans k�: - .. .
<br /> - - "*"*PROPERTY SUR1lEY requl[ed far,all.NEW..i;6ristruction.�� �' F ,.
<br /> <'['lirections:. �����--_.;^:��•. _. . , ��-... �F . . ' -
<br /> ' Fi{l��out�pplication compfetety. �
<br /> Owner Cantractor sign back of.application,notarized
<br /> If over$2500;a Natice of Commencement is required. (AIC�upgrades aver$75Q0}
<br /> �,�- ._ �;��.;.
<br /> � .,
<br /> Agent. for tiie ciant'ractoc)�or Power of'Attomey{for'tiie'oevner)woutd tie someone with natarized letter ftam awner authorizing same
<br /> �,,OVEF2`.THE COUNTER,PERiWi7'[ING . (copy of contraet-required}, '=�" : " �
<br /> � Rerciofs if sf�ingles Sewers Seroice Upgrades A(C Fences(PIotlSurveylFootage)
<br /> .�_:,::->;.,R_..:,:,,:�,,:_�e.; :m_:..,;:• ,
<br /> Drive ays-Not over Counter if on putilic roadways..needs�ROW, „
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