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� a�saeo-oa2o City of Zephyrhilis Permit AppFication Fax-813-780-0021
<br /> Bu'siding Departmen# .
<br /> L1ate Received � . � ' Phone Contact for Permitting = '� � �
<br /> Owner's Nam � ��� f����y -� C G� Qwner Y�hane Number ,
<br /> j y�.�4' � � � ,�c 3�°`� ��"` `� Owrner Phone Idumber �! �
<br /> Owner's Address � � ��e 6r
<br /> Fee Simple Ti leholder Name . Ownar Phone Number
<br /> Fee Simple Ti�leholder Addre�s
<br /> JO�ADDRESS ���' � �v'�� �1'� �'� Yt /t�"ll3 ��- N LOT# �
<br /> suaaivisio �c�r� ,��/J`'� � Q�c���Q# ,��, a-G �y( ��v! o � d 1�oc��' �b��
<br /> (OBTAINED FROM PROPER7Y TAX NOTICE)
<br /> WORlC PROP SED } I�EW CONSTR ADD/ALT � SIGN Q Q DEMOLISH
<br /> e WSTALL 8 REPAIR �
<br /> PROP.OSED �$E, . Q SFR Q COMM � OTHER �^-'''vc,�-
<br /> t
<br /> � 'fYPE OF CO STRUCTION Q BLOCK • Q FRA 0 STEEL Q -
<br /> � � � � { � ,� ���
<br /> DESCRIPTIO "OF WORK c,r -4�7- �C"r-o4i� -5�1�.+� ��. �'.�cz.L' �S �O(/T/� Jm p
<br /> ' � U:I�G�
<br /> �UICDiNG'SI E � � SQ FOOTI�GE�--� HElGHT !
<br /> OBU LDWG � � O� VALItATiCtN'OF-TOTAL CONSTf2UCTIOtV
<br /> C]EL C.T.RlCAL , $ �!� AMP SERVICE �0 PROGRESS ENERGY Q W.R.E.C.
<br /> QPL MBING $ ��
<br /> � ��C�J�
<br /> QM CHANICAL $ VALUATION OF MECHANICAL INSTALLATION �,.�� �
<br /> t
<br /> �G,S Q RqOFING Q'� SPECIAITY � OTHER
<br /> FIfVISNED.F�OOR ELEVATIONS � FLOOD ZONE AREA QYES NO
<br /> t 1
<br /> (� L- [s'4,f�t; �oµ rc l��'s .1� c
<br /> BUIL63ER G'"'�------"—" CONlP,4NY Z
<br /> SIGPIATUR � � REGISTERED Y/°N PEE CURRE� Y/N .
<br /> Acidress "o� �� ���.�z� � �G 33 t� �icense#' ���. C 3��Y i`I
<br /> r
<br /> ELEGi'l21C1 , COIUIPAI�lY
<br /> SlGNATUR ` REGISTERED Y/ N FEE CURRE� Y/N `
<br /> Aildre�s Cicense# � �
<br /> ;PCUNiBE�:. C�MPANY ,
<br /> � SIGN�iTUR REGISTERED Y�/ N, . �FEECURREi� YI N
<br /> Addre s License#`�� �
<br /> MECHANIC�l. , CQMPANY • . �
<br /> j SIGNATURE� " REGIS7ERED Y/.N. FEE CURRE� Y 1,N
<br /> Aiid're s:� � � � • License# �! � !�
<br /> ..�;�r.; - . . . , -
<br /> :..OTHER�" �� , � CONlPANY .
<br /> `SIGNATUR :�:; � � � ` REGISTERED ' Y/ N FEE CURRE� Y I"N
<br /> � Address,,.,, y _3 � . .- . � � � - ' L9cense# � �
<br /> '��RESIDEN7 � RttacFi;{2j=Plot�`Plans;''�(2)sets�.of°Bui!`cling-'Plans;�{1)set of Energy,Forriis;��R,O-W Permit;for.riew pconstruction, _
<br /> �;,�;,�_:;vY..�Minimum;ten;(,1'0)w.o,rkingGdays after.'sutimittal`date. Required`onsite;'ConstrucGon Ptans,,S#ormwater Plans vv!Silt Fence.instatled,
<br /> -- -� - � Sanitary Faciiibes&1 dumpster Site; .W.ortc°Permi#f6r:subdi'visibns/iarge:prbjects f= ' ` -- ' '
<br /> ,.-�,GOti�MER lAIL. Attach°{2}'compEete sets"of Builiiing Plans pius a Life�Safety Page;{1)set of Energy Forms.R 0-W Pecmit for new construction.
<br /> > Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,5tormwater Plans w/Silt Fencer'installed,
<br /> . " Sanitary Facilities$�1 dumpster.Site,Work Permiffa�ait new projects.All commercial requirements must meek.compiiance _
<br /> `=.�SIGN�PER�IT Attacti(2j sets�of:Engineet�d Rlans��c: -? : : `
<br /> ***"PROPERTY SURVEY requlred far_al1.NEW coristruction: �
<br /> ;.:.'�irections .._. -`$:n�,A - , , � .
<br /> �.FN!'ou applicationcompletely.
<br /> � Oiivne &Contractorsign back of applica8on,notarized
<br /> . if ove $2500,a Notice of Commencement is required: (A/C�upgracies over$�5d0}
<br /> �,.�,},:
<br /> " Agent,(fo��tiie'coritractbr)�orPower,-af Pittbmey(for`ttie or`rvner)would be someane with natarized letter fram owner autharizing same
<br /> �OVER.TN COUNTER.PERMt'RiNG:.>:�>.(copy_oficontraetrequired}.,`. -- �� '
<br /> --Reraafs if's ingles Sewers � Service-'�ipgraides�A/C .4 Fence's,{PlotlSurveylFootage)
<br /> . .,.,�, ;.�. „ �
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<br /> .�. ...., ...... .. -{i,:r.i'�t T:�i ' .' �. �
<br /> Drlve ays-IVot over Counte�if on public roadways`.neads ROW`".r;, �
<br /> .,. ,. � ..,�. _, • , � :;r.
<br /> ,_ .:...�..,a. ., ...� .....r w.. . F .._ ..,.. .
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