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. s��- saoa?o City af Zephyrhilis Permit Appiication Fax 813-780-0021
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<br /> � Buildfng Department
<br /> Date Fteceive , ti �� �r� - .5���
<br /> � • Phone Cantact far Perniitting '`
<br /> Ov►+n�r's�l�m �'!`y''r ! 5`/`7 l�!!�/"'��< � Owner Phone Number , ���-�����o?U
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<br /> Owner"s:Addr ss �J� . � � D7�"j /�/�"� Owrner Phone Idumber
<br /> Fee Simple Tctlehotder hlame ` Owner Phane Number
<br /> � ... ,_..,_� ��.. �
<br /> Fee Stm le T'tteholder Address
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<br /> JOB�DfitE �S ��7� jsll�'�L5`7"Y) LJ LOT#
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<br /> S��Q�v«�� �������as�o� �� �,�����a# l� � �� �17 a��a� ac���
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED . e' . NEW CONSTR AGD/ALT � SIGN Q Q DEMOUSH
<br /> INSTALL - REPAlR
<br /> PROP,OSED SE .. Q SFR Q COMM � OTIiER`
<br /> TYPE OF CO STRUCTION Q BLOCK • Q FRAME � S,TEEL [�
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<br /> DESCRIPTtO 'OF WCtRK �,- '�G � A-nJ� �-L`x ce-'T � .G'-r�rr� �N�n17'S � 7'
<br /> BWI:D{Nf`$t E ���l� SQ FOOIAGE .liElGHT �, �
<br /> �BU LDING � � VAl.UATIOf�=QF"TOTAL CQNSTRUGTlON
<br /> QEL CTRICAL . $ �� AMP SERVICE =Q PRQGRESS ENERGY Q W.R.E.C.
<br /> QPL MBING ��
<br /> QM CHANtCAL $ . VA�UATION OF MECHANICAL INSTALLATION
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<br /> QG,S Q ROOFtNG Q SPEGIi4LTY � OTHER
<br /> FINISHED F OOR ELEVA710NS FLOOD ZONE AREA QYES NO
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<br /> BUILDEF2 � � COMPANY
<br /> SIGNATUR _^,�_ ,! REGISTERED Y/'N FEE,CURRE� Y I N
<br /> Addres License# �� �� �
<br /> ELECTOtIG! COMPANY
<br /> � SIGF�ATUR a REGISTERED Y/ N FEE CURRE� Y/N
<br /> AdcEres � �9aense# � - '��
<br /> PLtilUIBER._;, COMPANY „ ,
<br /> SIGNA7UR �REGIS7ERED- �Y�/ N _ �FEE GURRE� YI N
<br /> Acidre s � Liaense-# �— - ' �
<br /> ,..MECH.'AN{C `� ��1 '''� `` COAlIPA1dY /��R fi.S 6`D /��. '�`�'L° ..�-!1i iL
<br /> . ,SI(aN�iTUR `` ��� ���'' REGISTERED - Y/ N FEE CURRE� Y/N
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<br /> Aildre s:: ��'��� � ��ILL'�"'�„i^ �icense# �tT w�� �� � 1
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<br /> OfiNER� w":�: � " CO11flPANY- ' .
<br /> `: 'SIGNATU :� � �� � � � � � REGISTERED � Y/'.N FEE CURRE� Y/N
<br /> Addre�s,., , � _. _ � . _ � � � License# �—.—i.—l�
<br /> �`.RESlDEPlTI �:' Attach.(2)";Plot'�Plans;'�(2)ssets iif8uiltiiiig•'Plans;'(1j�set of Energy For'rris;'�R,C1-W Permit'for`new'construction, -
<br /> — d,..-v-r�, - �.= A � .. . , �
<br /> ��•�a: :��x� �^Mini,mum'�ten�_(�10)wo,rking;iJay.'s�after,submittal;date. "Requir"ed on"site;�Construction Plans,;Stormwater P1ans w/Silt Fence installed,
<br /> _ 4y'..�.°.r.,-4�b���,I;x 4y„.i...�.....r - � � � , �
<br /> Sanita:ry.,.;Fae%IitiesN&.,1:�dumpster Sife:�Nork Perrn�t#orsubdivisionsllarge.projects.� ' . `` `
<br /> :,.,GOMNiERC A[.. Attach''(2j�coriiplete"'sets of'Builcling Plans�pfus a Life 8afety Page;{1)set of Energy FoRns.R-O-W Permit for new coristruction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,Stormwater Plans w/Silt Fence:installed,
<br /> Sanitary Facilities&1 dumpster.Site,Work Permit fo�a0 new p�ojects.�AN commercial requirements must meet comptiance
<br /> ';SI,GN'`PER �IT Aftacfi"{2}sets afSErigineetQcf S?tans:�,. f . , "
<br /> :� "*""PRaPERTY SURI/EY_requlred for_aU:NEW cc,nsUuction. �
<br /> '=D�rec'tRons: .:,:�, . �. , _ ,.
<br /> , .Fi4{:ou app{ication campletaly. '
<br /> = Oinmer&Gontractor sign back of�application,notarized
<br /> If ove $2500,a Notice of Commenaement is reguired. (AJG upgrades over$7500)
<br /> ,. � •='���„<;.:��,;;,
<br /> Agent for the�cantractor)`or Power df-Flttbmey(fo�'ttie�ovuner}wauid be sameane with notarized tetter fram awner autharizing same
<br /> ,'01fiER'THE CCIUNTER;�PERMITfING ..,. .(capy=of-cantract�requir.ec#)"., , ' "
<br /> �Reroofs if"s ingtes S'ewecs Service Upgrades�'i47C � Fences�(1?lotlSurveylFootage)
<br /> �._. .._._._.� .;�....._ ,,., ,._ :
<br /> Drive ays-Not over Counter if on�public,roadways.;�ieeds I�OW;' '
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