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�- s�3asa-oozu City of Zephyrhilis Permit Appiication Fax-813-780-0021
<br /> � 8uilding Departmenk _
<br /> Data Recelved� °
<br /> ,r. • Phone Contact for Permitting - – •
<br /> Owner's Name �� ^ Owner Phone Number . �I ���a�" �a �
<br /> Owner's�Addr ss � � 7�' Ol� Owner Phone Number �— �
<br /> Fee Simple TiE eholder Wame � � Owner Phone Nvmber �— �
<br /> � �
<br /> Fee Slmple 7i�Iehold�r Address �
<br /> JOB ADDRES5 tu � � L.QT# ��
<br /> SUBCIiVlSIQM �— � PARCEl.!D#
<br /> (OBTAIIdED FRqM PROPERTY TAX NOTICE)
<br /> WQRK PROP�SED . PIEW CONSTR ADD/ALT � SIGN Q � Q DEMOLISH
<br /> � , e. INSTALL 8 REPAtR . �
<br /> PROPOSED' �SE.. Q SFR Q COMM 0 OTHER
<br /> TYPEI'OF CO STRUCTION Q BLOCK - [� FRAME � STEEL Q
<br /> DESCt21P'fi0 OF WOitK � � �t31`�1�"y d.J-�' �M`� Gj� . � /�r f
<br /> v1
<br /> �BUILDti�G'St E � !�� SQ FQOTACsE�� HElGHT ��,_,� t
<br /> I
<br /> [�BUI DING $ �—�, i,--� VALUATlON°Q,F"TOTAC GONSTRUCTlQN' `
<br /> ���� o�K'�'9�4 .
<br /> �EC�CTRICAL $ AMP SERVICE �Q PROGRESS ENERGY Q 1N.R.E.C.
<br /> QPL-�MBING � � . i,,...1,
<br /> �.,.
<br /> �..1�A 10�../
<br /> OME HANICAL $ VALUATION OF MECHANICAL iNSTA�LATIOIV 1V
<br /> OGA Q ROOFING Q SPECIALTY � OTHER �� � � ��
<br /> FINISHED.F OR ELEVATIONS FLOOD ZONE AREA QYES , NO
<br /> ��,�� �
<br /> _'._' r
<br /> Bt3iLDER CO�flP�RP1Y ' � � /'"7 G-�
<br /> ) �4
<br /> SIGWATUREI �� /j �✓ L��' REGISTERED Y/'N FEE CURRE� Y/N
<br /> f ..,
<br /> Addres � u� � � r v`�"Z. f'"�- License# �i ��
<br /> , ELEC;TRt.CI CdflAPANY .
<br /> � SIGNATURE, ' REGISTERED Y/ N FEE CURRE� Y 1 N
<br /> Addres Cicense# � ' �
<br /> � -- ,
<br /> PLUMBE�;.'_ CQMPANY'
<br /> SIGN14TURE �REGISTERED• Y�/ N . FEE GURRE� Y/N
<br /> Addres � � license# ��ri� � �
<br /> ;�.�i4�EGHANIC� . � C0IIAPR[dY .
<br /> :SIGNATURE�' ` ' " REGIS7ERED Y/,N- EEE CUrtR�n, Y/N
<br /> � lAtld�esl , , � , � ' � � License.#
<br /> ...:;�1, . --
<br /> =OTHERa� '"� " _ ' � COlIA,FANY -
<br /> '='SIGNA'T;UR ':; ' j REGISTERED Y/.N- FEE CURRE� Y/'N
<br /> Addres .<,, i-.� ;sx:,: � - ° ' - � ` llcense# � ��
<br /> ��; .
<br /> ;I-.RES4DENTl �� AttacFi:(2);Plof=Plans;(2):sets�of�Buiidfng=Plans;•(1�)�setof°Energy_Fomis;�R-O-W'Permit�for.newconstrucGon, „
<br /> ��� --�� �•�Minimum}oten;(:10.)working;days�after:"sutiini#tal:d'ate.`Required onsite;Construction Plans,Starmwater Pians wI Stit Fence instatled,
<br /> ,.,i'v s,;, h.
<br /> ._....,.;..�,. , . ,.
<br /> 'San.itt�.ry4,Faeilities;&„1,.dumpster;Site; ,W.ork�P.ermit'for••.subdivi§ions/iarge�,projec#s- - -
<br /> ..GOMMERG AL. Attach�{2}�cainpiefe sets of'Buitiiing�Fians plus a L'sfe�Safety�Page;{9)set of Energy Forrns.R-O-W Permit for new coristruction.
<br /> Minimum ten{10�warking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence•installed,,
<br /> - Santtary Faailities&1 dumpster,Site Work Permit fo�-alt new projects.Atl commercial re,quiremenfsmust meet compliance
<br /> =`StGIV�PEF2M6�!'F A#tactt(2)sets�of:�Engineer$cS Ptans:t: .,;- . :_ , ' . - , �
<br /> """FROPERTY SURVEY required far.aU.NEW coristruction:
<br /> '��[1i[ei�tiorts: ,��:�:�� ,. ., � .�
<br /> � � Fitt.�aut��ppfication completely,~�t
<br /> _ Ou'vner 8�Gontractor sign back of application,notarized
<br /> if over�$ZSQO;m Natice of Connmeric�m�nt is r�quired. (,41C upgrades over$7500)
<br /> sx �tzi.,::;;.;.�.,;s: ; � �- �'h , 4 .,. '- ,
<br /> Agent:(fior ttie�cont'racfar}or Powetryof Attomey(#6r'ttie`oiivnerj wrauld be someone with notarized le#fer from owner authorizing same
<br /> � ,QVEtt`THE.COt1NTER pERMi1'CiNG._. .(oopy,of-contrae#:required) .
<br /> i:^-_._.......
<br /> Reroafs if st��ngles Sewers Seroice Upgrades A/C Fences(PIoUSurve}rlFoatage)
<br /> � _ ___.. . ,.,, , ., .:,..u:.�>..r.,.._.�:,�.<,,:.,,,�,:;>_,,.,:.....«... ...
<br /> DriveH�ays-Not over Counter if on:public roadways.:needs�;ROW°
<br /> ' ���i: � ;5 � . . , . � . . ,��
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<br /> F...,. .......9,. .w_..,.-.+<,sx�n..a....: ...,,.�.�_...�.r�
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