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<br /> �- 813.� o-oozo City af Zephyrhiils �ermit Appiication Fax-813-780-Q021
<br /> . ' Building Llepartment .
<br /> D��e����`�� • Phon�Contact fo�Perrriifting ' –
<br /> Owner's tdame !�LJ,� f�� � �� Owne,r Phone Numbe� . ,r
<br /> 4wner"s,Addr ss Owner Phane Mumber �� �
<br /> Fee Simple Tit eholder Rlame. �� � Owner Phone Number �^ ��
<br /> Pee Simple 7i eholder Address �
<br /> JQB ADDRES �'S�� FI S , �QT# �
<br /> SUBDIV1810N �— � PARCE�fD# "' "'�d�l�"-- �..��a `� /.�
<br /> (OBTAINED FROM PROPERTY TAX PIO7ICE)
<br /> 1NORK PROP�SED NEw CONSTR ADDfALT � SIGN [� � Q DEMOLISH
<br /> e � � INSTALL 8 REPAIR ,
<br /> ` PROP,OSED SE . Q �uFR Q� COMM � OTHER
<br /> � TYPE OF CO S7RUCTIOPJ - L`,� BLOCK - Q FRAME � STEEL Q ,
<br /> DESGRIP'�IOW OF WORK ` ` lL.(7 !�-D� OG{ �" 'vU� 17" �� , J!7`j��� ��'9�f1� �/�;'"�
<br /> � �UIL'13ttVG St E �^�, SQ FOOTAGE� t{EtGNT � ,.��
<br /> � QBUI DING � �� VALUATIt3NYQF=TQTAL G0f4STRUGTtON � �
<br /> [�EL CTRICAL , $ AMP SERVICE '[� PROGRESS ENERGY Q iN.R.E.C.
<br /> �PL MBING �� �j � �y t L
<br /> � " J ��f
<br /> QMECHANICAI. ' $ VALUATION OF MECHANICAL INSTALLATION
<br /> 0G,�S - ROOFING SPEGIA�TY C� Q7HER 7�� �
<br /> . I f'""I Q ,
<br /> FlNlSHED F QOR ELEVATIONS � FLOOD ZONE AREA ��YES NO
<br /> BUILDER CQNlF�1tdY
<br /> SIGPlATURE REGISTEREp Y/-N FEE CURREn Y/N
<br /> Addres License# �� �
<br /> ,: 3G - �
<br /> ECEGTRiCI,. COAflPANY
<br /> .. SIGlVATIlR ° REGISTERED Y/ N FEE GURRE� Y 1 N.
<br /> �
<br /> Addres Ctcense:# � � ,
<br /> F�tUMBER;_- , , GOMPANY� "
<br /> SIGNATUR ,. REGISTERED- Y*/ N FEE GURRE�- Y I N
<br /> Addres L3oense#�C— � �
<br /> , .�MEGHAi+tiC ' GOMPAP�Y
<br /> SIGNATUR ' " ' " REGISTERED , Y/.N FEE CURRE� Y!.N
<br /> Add�e s� ' � , License# r �
<br /> s..:¢�,-�;. �3 ... . : . . - �� �' ' . . . .
<br /> o�+�R-: q�� . r .. { — , co�n,Pa�iv � rl����D,%�r�,� -
<br /> �_'SIGNATUR v: ' - � REGISTERED Y/N . FEE CURREri Y/N
<br /> Addre..s;:-� :� .�d-'�.,, _ � ���'"���f ��-- „ License# 1 lU--�p y�.`=�f�
<br /> .. .,. �,:; , - :
<br /> �,'.RESIDENTtAL`,.;` AEtacFa�(2);Piot'PEans;{2):sets-of'Building�Plans;_(1)`set'of�Enet�yyForms;`R-0-W�P.eirriitfor.new�construction,
<br /> -<.,.�,.. .
<br /> �,� a:;,:-„F����Minimum:terr(;10�inrorking;day,safter,'sutimittalydate. Requir'ed onsite;�Con'struction Plans,Starmduater'Pians w!SIIt Fence installed,
<br /> - �.�:�.-��..u,� : _ ;. . ,
<br /> w Sanitary;;Facilities�&;1;�dumpste,r,•,Site;Wortc�Permit foc'.subdivisigns/large:prbjects•�
<br /> >,G�WiMER IAL. Attaot��(2}�iiotri'piete sets of`Builii�ng�Piarrs�pius a�L�fe Safety Page;{'!)set af Energy Forms.R-O-W Permit for new canstrucGon,�
<br /> .F � Minimum ten{1q)working days after submlttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence:instalied,:
<br /> ` Sanitary Faoilities&1 dum,pster.Site Wor}c Permit fo�al1 new projects.AI1 commercial requirements must meet compliance
<br /> _��::SIGN PER IT AttaicFi(2j sets crf:Engineec�d F?tans:��� - � �
<br /> � ""'"PROPERTY SURVEY requlred for.aU.NEW-consVuctian. - �
<br /> �"'Directians• _.. .. ,.- �, � __
<br /> � .Fiil-oa applica�ort campletely.
<br /> , Ovlrne '8 Contractor sign.beck of applicatlon,notarized
<br /> If ove $2500,a Notice of Commeroaem�nt is required. (A/C upgrades over$75d0)
<br /> ..
<br /> �.=s:
<br /> - Agent�(for'fiie'cont'ractor)orPower'of Aftomey(for`ftie oii4ner)wouid be someone with notarized ietter ftom ov+mer authacizing same
<br /> �;��QV�R.'1'HE COUNTER:;P._EitMtT,TiNG__. .(copy.of bontraef-required} ' '
<br /> � Reraois if s figtes Sewecs'�''-�'""Seririce`tlp�ra�les'��fCIC""��'=:;�eiices(PlatlSurveylFaotage)
<br /> 1. ..1,. _ � � ;! .
<br /> Drive ays-Not over Counter.lf,�onrHpubiic roadways,;n'eeiis RONl:`` �
<br /> y ., a .-.;�..,;�_ , �- - -,
<br /> d .�,��;I.: ,... ,.'r.�+1.. + � �
<br /> `t«�...v.y-...t...-er.,.,,a.<-�;.:x..�:�:.,r✓sx.:.-.�•�...:...1:__. .
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