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8'l3-7B0-0020 City of Zephyrhilis Permit Application Fax-813-780-0021 <br /> Buiiding Oepar#man# <br /> Date Received f f .�s ' ' 7�"'�3 _ S�/�' <br /> 1 • Phane ConEac#for Fermift�n <br /> Owner'sName l., ��� �G M/�i� Ow/nerPh,odneN�e ��� <br /> 9 � <br /> .r �l�—a��/ ' o���l l <br /> �� 6_.. ML�j t� •J�P" .�I� t�G[QIr-RL � � <br /> Owner's Address �'" dwner Phone Number <br /> Eee Simpis Titiehotder Name � � Owner Phone Num4er � <br /> � Fee Simple Titlehoider Address <br /> ', JOBApDRESS `�fG[� ��{�?2'(�L� ����4�] ��» 33�� LOT# o��� <br /> StlBDNtStdN �L�$$�"'1 C G,F S PAE2GEL 10�f � �-�o cr�-� - C1� `QVI t1V'Q V�� <br /> (OBTAINED FROM PROPER7Y TAX NOTICEj <br /> WORK PROPOSEp e NEW CONSTR� ADD/ALT � SIGN Q Q DEMOLISH <br /> tNS7A�L REPAIR <br /> I PROPOSED USE Q SFR Q CQMM � OTHER <br /> �' TYPE pF CONS7RUCTION Q BLOCK Q FRAME � STEEI. Q <br /> DESCRIPTION OF RK ' � �;(' �+L( f�T1�YL1 at k'� ��LjkC�'�T�- <br /> BUILDtNG 3t2E `S�'n trOt�.- )`7j'Xl�{ SQ FOOTA6E �y r� � HEIGHT �_____� <br /> TRT'TI"1"'I�T /[T����1�1"'f�TFTi�iT'1'TrTf�TrP'TTI�LTTI"rrl"1'Y'Tr["1"'1"1"1"I�I�rIT'Pf�T�' <br /> �UILDING �' <br /> � �,� �� 4\VALUATION OF 70TAL CONSTRUCTIOPS <br /> t QELECTRICAL $ _ ... �AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> PLUMBING $ ���� <br /> � . G ''� � <br /> � �� <br /> �tNECHANIGA� �� VALllAitON OF MECHANlCAL INSTALLATidN � <br /> _ �� .,��� <br /> OGAS Q ROQFING Q SPECIALTY 0 OTHER �� ✓ �tt�� <br /> FIh31SHED FtOOR ELEVATIOtSS FL40D ZONE AREA QYES NO �1 �j� �` t � <br /> I t �%] <br /> -.-;-�*-0-T;-..�-�:-.-,r.�-.-C-:-r;--.�-.-r.-:-�-'•-�:-'•-:-•-��:-:.Y:-:-F-C-�:�-A-:�-:-C-�-�;-C-:��;-�-T:-:-;r:-rC-. <br /> . � <br /> � �� -j�, <br /> BUILDER /��� '� (�' COMPANY GI C4"�"Y ! GC k" � <br /> SIGNA7URE '�^3 REGISTEREO Y/ N FEECURREA Y/N <br /> Address ,�"r "}�'jC� I�`1� ���'�/i License# �����0 �J �� <br /> ELECTRIGSAN � � G4MPANY � <br /> SiGNATURE RecIs7EREo Y/ N p�curu.en Y!N <br /> Address License#� � <br /> PLUMBER � � COMPANY � <br /> SIGNATURE � REGIS7ERE0 Y J N FEE CURREA Y/N <br /> Address License# � � <br /> MECHAhI1GAt � � GOMPANY � � <br /> SiGNATURE REGIS7ERED Y! N FEE CURRE� Y 1 N <br /> Address license# � � <br /> OTHER � � COMPANY � <br /> SlGNA7URE � REGIS7ERED Y/ N FEE CURREA Y/N <br /> Address License# � � <br /> IIIIIIIIIIIII.IIIIIIIIIIIIIIIIIIIIIIIIIIIt1111111I11I111I111tI1i1111 <br /> RESIDENS[AL Attach{2)Pla#Ptans;{2}sets oE Suiiding Pians;{1}set of Energy Farms;R-0-W Permit for new consWction, <br /> Mfiimum ten(t Oj working days after submiffai date. Required onsite,Construcfian Ptans,Stormwater Plans w/Siit Fence instalted, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsAarge projects <br /> COMMERCIAL Attach{2)complete sets of Building Plans pius a Life Safety Page;{1)set of Eoergy Forms.R-0-W Permit for new consVucUon. <br /> Minlmum ten(10}working days afler submitfal dafe. Requtred onsita,Construction Plans,Stormwater Plans w!Sift Fence instatted, <br /> San(tary Facilities&1 dumpster.Slte Work Permit for aIi new projects.Ail commerc(al requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for a(t NEW canstrudlon. <br /> ! .�I-l--{-i.-S-t-i-i-i-i-i-t-I-i-1�-t-:-.�C-C-1-i-I-t-�»i-l�i-�-�i-I�-t-R.i-�-t�-F-t-�-F-t-t-I-�i�i-i..1-.I-t-t-h-4-t-1-�i-1--i-i-S-�Fl--t-i-. <br /> Directians: <br /> Fill outappllcation completely. <br /> � Owner&Contractor sign back of applica6on,notarized <br /> I f• If over$250Q,a Notice of Commencement Ss reqaired. (A!C apgrades over$754d) <br /> Agent(for the contractor)or Power of Attomey(for tha owner)wouid be someone with notarized lerier from ovmer authodzing same <br /> 4YER THE GOUNTER PERMSTfiNG {capy of canfract required) <br /> IReroofs if shingfes Sewers Service Upgrades AIC Fences(PIot/SurveylFootage) <br /> ( Driveways-Not over Caunter if on public roadways..�eeds ROW <br />