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813-780-002o Ci of Ze h hills Permit A licatian Fax-813-7$0-ao2� <br /> _. �Y P Y� PP <br /> , Buiidfng Department <br /> _ . ' . <br /> Date Rsceiwe ' �' _ <br /> �1: �'�Phone<Cantact for Parmttti» - <br /> r r. <br /> �'i - <br /> Owner's tdam • � �wn Phone Nem er��� . � �� <br /> � <br /> Owner's Addr�ss �� � � ' -Owner Plione Number <br /> Fee Simple Ti leholder Name Qwner Phone Number � � <br /> {•i� � � .. <br /> Fae Simple TI leholder Address ` <br /> JOBADpRES ��� �/ ' I.QT# �__� <br /> SUBDIYISION � � PARCEIID# ' <br /> (08TAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP SED -NEtfit CONSTR ADDIAl.T Q SIGN {� Q DEMOLISH <br /> , INSTALL � REPAIR <br /> PRQPOSEDt SE SPR � COMM "Q OTNEi2 <br /> TYPE OF GO�STRUCTION • BLOCK " Q FRAME � S7EEC Q <br /> DESCRiPT10�OF WORIC . ��� `•..�r"�/C� <br /> BUI�DING Sl�E` �� � Sti F04TAGE " HEIGHT � ,.� <br /> QBUILDING $ ��i'"J 9� �ALUATtO1V`OF 1'C3T11L COt+iSTFtt1C'1'IQi� <br /> C/ <br /> QELECTRiGAt. $ W� AMP SERVICE Q PROGRESS ENEftGY � W.R.E.C. <br /> QPL MBtNG $ '� — <br /> QME�HANfGAL $ ' � VAl.UA3lONOF�MECHANIC,4lINSTAI.tAT10N <br /> QGAS Q ROOFlNG .Q SPEClRLTY Q OTHER <br /> FIfVISHEp FLOOR ELEVATIONS FL04D ZONE AREA [�YES. NO <br /> - •a-' ' _ _ _ -_ ' - ' - _ _ <br /> BUI�DEit ' f COMPANY_ �JC„r....� <br /> SiGNATUFtE � � , REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �� � <br /> El.ECTRICIAld Ct?MPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�° Y/N <br /> ����� � License# � � � <br /> P�UMBER COMP.ANY � <br /> SIGNATURE" REGISTERED Y/ N FEE CuwtE�� '" Y/N. <br /> Address i.icense# I �� <br /> NlEGHANlC � � COMP_AN1C <br /> $IGNATURE ' � REGISTERED Y..,/ N FEE CURF3E�. Y/N <br /> Address , . _ L:icense# �, , � <br /> OTN�R � �... , . . <br /> .COMPAPIY <br /> SIt3NA7�IttE �� - " � '� REGISTERED ' Y/ N,, -FEE CURRE�' Y/N <br /> Address ' " - � Ucerise# ( �� � <br /> 3. . . _ �.,,.. :.�.r;r, �� :� ,-,,... .... , � <br /> RE8IDENTi '.•� AttacFi"(2}rRtdt�P.,lans;.�{2)"s`efs:of�Butidingf Alans;{1)set of Energy�Fa`rms;Ft=O=W Rerrriit for new const�uction, <br /> „ ,>�Minimum�ten�(10);worlting;dayswaftei;s"ubmlitai�tlate::'R'equlred onslte;`Co"nstitieU�on=Pl�ans;Starmwater Plans w/SiltFence Instelleii, <br /> � Sanlfary FaGltties:&=1.,dumpste,r,;Site;Work;P.,ermit,#qr�su6divislonsAarge.proJects_. " '� " <br /> CQOfIMERCI Attach(3}-carnplete'sets"'of Bultdiiig Plans ptu�a Ctfe"Safety Page;(1}set af Energy Forms.R-O-W Perm�t far new canstrucHan. <br /> � Minlmum ten(10)working days'after submtttal date. Required onslte,ConstnucUon Plans,Starmwater Plans w/Sllt Fence fnstalled, <br /> Sanitery Facllltles&1 dumpste�.Slte Work Permit for all new proJects..All commerclal requlrements must meet compllance <br /> StGN PERMt� Attacti'"(2)sefs'of Eng}rieered�f?fans.,,:�:---. ,. <br /> ""'PROPERTY SURVEY reyulred for all NEW consWctlon. <br /> D1�eatlons: . ° <br /> Flll out a plicatlon completely. <br /> Owner&Contractor slgn back of applicaUon,notarized <br /> If over 5�500.a Nctice of Camm�ncemeM Is rsqulr�d. {J�1C upgrades aver STS00) <br /> " Agent(f�r the contraator)'or Powe�of'Attomey�(for tFie owner)would be someone with notarized letter irom owner authorizing same <br /> aVER THE C�UHTER PERM17T1NG - {Front af Appltca�an O�ly} <br /> Reroafs If shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Faotage) <br /> D�ivewa�ta-fUat over Caunter if on publlc roadrvays..tieeds ROW <br />