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t� <br /> t <br /> 7 <br /> _ - 813-780-0�20 City of Zephyrhiils Permit Application Fax-813-780-0021 <br /> � Building Departmenf <br /> Date Received Phone Contact far Permitting �S 6��1 — 7�+ 7� <br /> � �—r�—r.r-rrri <br /> Owner's Name �1�� F�+o 6�P"f' L!�'..' TI"" Owner Phone Number o�3�7g8-29�9 � <br /> Owner'sAddress 383Zid / �C • <br /> Owner Phone Number S'�3-'7!3'��Z� <br /> Fee SimpEe Tit[eho[der Name �—_ � Owner Phone Number �— � <br /> i <br /> I <br /> � Fee Simpte Titlehotder Address <br /> i JpBADDRESS 3S�Z0 IY'I'LI PdV� �'1'rS Y,�.. 33",�"�yZ LOT# jZ34� <br /> susa�vrsioN �� PARCEl.ID# �1•2.G�.!`dd td-b 2 A!►-Dt3! <br /> (OBTAINED FROM PROPERN TAX NOTICE� <br /> WQRK PROPOSED e NEW GON57R 8 ADD/ALT C� SlGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR � COMM � OTHER t�f'e9df .�i�'liot,��/y► � <br /> � TYPE 6F GONSTRUCTtON � BL4CK Q FRAME � STEEL Q �� � <br /> � <br /> I �j� <br /> � DESCRIP710N OF WORK {�yy► S � r� +� �'� , �JAF� S�� S <br /> ! <br /> BUILDING SIZE �—� SQ FOOTAGE I�4 HEIGHT �� <br /> QBUILDING $J����.� VA�UAT10P1 dF TOTAL CONSTRUCTION <br /> 7 <br /> QELECTRICAI. �� AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ -/"� �j �� <br /> � � � t � <br /> � QMECHANICAL $ VACUATtON OF MECNANICA�INSTAl�AT10N <br /> � QGAS � ROOFING Q SPECIALTY C� OTtiER <br /> I FINISHED FLOOR ELEVATIONS �� FLOOp ZONE AREA �YES NO <br /> I <br /> I <br /> BUILDER � GOMPANY � � <br /> � StGNATURE REGISTERED Y/ Id FEE CURREA Y I N <br /> i <br /> � Address License# <br /> , EI.ECTRiCIAN COMPANY �— � <br /> I <br /> � SIGNATURE RE6ISTEREp Y! N FEE CURRE� Y/N <br /> Address �icense# �_—_� <br /> � <br /> IPL.UMBER � COMPANY �— <br /> � SIGNATURE REGISTEREp Y/N PEE CURR£A Y/N <br /> I <br /> i Address License# � <br /> � � <br /> I <br /> I MECHANICAL � CdMPANY <br /> i SIGNATURB � REGISTERED Y I N FEE GURRE� Y/N <br /> I <br /> � Address �� License# �— <br /> j OTHER �` �_ GOMPANY N�.WNq, ��i1�q �"�'G I <br /> ( SIGNATt]Fi8 REGISTEftED Y I PI FEE GURftEA Y 1 S�I <br /> Address d �', CX�rY11MG/'GG' � S �'I X FL �`"js7� License# ��=.�3'�.k�s��(�� <br /> 1 t [ I ! I / 1 1 ! / i i t / I i I 1 1 1 I / / ! 1 1 1 1 1 i 1 t i I i t ! 1 1 1 ! { f t i ! 1 1 1 1 ! ! 1 1 1 ! 1 1 1 1 1 1 1 1 1 f <br /> RESIDENTIAL Attacfi(2j P3ot Plans;(2)sets of Building Plans;(1)set of E�ergy Forms;R-O W Permit for new canstruction, <br /> � Minimum ten(10)warking days after submirial date, Required onsite,Constructian Plans,Stortnwater Plans w/Silt Fence installed, <br /> � Sanitary Fecilities&'t dumpster;Site Wor1c Permit for subdivisions/large projects <br /> � COMMERGIAL Rttach(2}complete sets of 6uitding Plans pius a�ife S�fety Page;{1)set af Energy Forms.R-O-W POtmit fot new cansVucUon. <br /> � Minimum ten(10)working days after submitta�date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence insta2led, <br /> I Sanitary Facilities$1 dumpster.Site Work Permit far all new projects.All commercial requirements must meet compliance <br /> � StGN PERM{7 Attach{2}sets of Engineered plans. <br /> � '""PftOPERTY SURVEY required for afl PlEW construction. <br /> I <br /> � Directions: <br /> � Fili out application compietely. <br /> Owner&Contractor sign hack of apptication,notarized <br /> i If over$2500,a Notice of Commencement Is required. (AIC upgrades over$7500j <br /> «« Agent{tor the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> i OVER THE COUNT6R PERMI7TING (copy of contraat requiredj <br /> ' Reroofs if shingles Sewers Service Upgrades AIC Fences(PIoVSurvey/Footage) <br /> I <br /> � Oriveways-Nat over Counter if on publia roadways..needs ftOW <br /> ( <br /> I , <br /> I <br />