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i� � <br /> 893-780-0020 City of Zephyrhi!!s Permit Application Fax-813-780-0021 ; <br /> Bulfdin�Departmen# <br /> i� <br /> Dat�Receiived _ <br /> Phone ContacE for Permitting � � <br /> ._.B.w�..�..&_.�_.�..`�.. - - _ _�."� y'""E B <br /> Owne�s�tame `�Q Owner Phane P}umber -/� _ <br /> a �1 � <br /> tlwn�r`s Actdress l,._..C1YY1.� Owner Pfrone Numbar � <br /> Pee 5imple T9tleholder lVam� � � Quunar Phc�ne Idumber �� � <br /> Fee SimptQ 7ftleholder Address <br /> J08 ADDRESS `Z� � �(� L01'# �r_� <br /> 3U8�DNfSt'O�d IC3l��l�(��c „� � PAitCEi.ID# C700C�t9 <br /> {QBTAlMED PROM PROPERTY TAX NQTtCB} <br /> WI3i�i(P��POSED e NEW CONSTR 8 ADDIAI.T � SIGN [� [� DEMOLISH <br /> INSTALL REPAIR <br /> PRt7P{}S�D US� � SFR Q COMM � OTHER 1 <br /> TYPE OF�OPISTRUCTIOIV � BLOCK Q FRAME [� STEEL [� <br /> DESCRiPTION OF WORK ��V1 � � <br /> � ��.�.� �� k <br /> BUILDIRIG SIZE SQ FOQTAGE HEIGMT i <br /> ���1L����' � ���� VALUATION OF TOTAL CQNSTRUCTION � <br /> a <br /> ��I LECTRlCAL $ A(vIP SERVICE Q PROGRESS ENER�Y �] W.R.E.C. <br /> [�F'LtlNIS#i�1G $ (� /���� <br /> � �i I f <br /> �t-i � <br /> QMECF4ANlCAI. $ VA�UAT10�!{}F MECHANICA�#NSTAl.CATfOiV �� � �('T/� <br /> i <br /> (��as � �oaFrta� Q s��cwr�zY � o�rt�� � <br /> FINISHED FLOOR ELEVATIONS �LOOD ZONH AREA QYES NO <br /> � <br /> BU!l.DER I � GOMRANY �- .Q. ��'(�- �.P_ <br /> SIGNATU6�E RERISTERED Y/,AI- FEE CURREP <br /> � <br /> Addres� �'� .fZ i��� `ii���� �3S�Z. License# C�...i ot'� <br /> EE.ECTRtC1AN COMPAI�lY <br /> SIC'+PIATURE REGISTEREp Y/ N FEE CURRE� Y/N <br /> Addreas tJCense#� � �� <br /> Pl.UMBER� COMPANY <br /> S1Gi11ATUFEE � REC3ISTEREp Y/ N FEE CURRE� Y/N <br /> Addr i s License# �� � <br /> � <br /> MECN�lICAL COMF,4l+�Y <br /> SICaNATURE REGISTERED Y/ N FEE CURREI� Y!Pl <br /> Address �icense# � �� <br /> 07'HER � COMPANY ; <br /> SIG�tATU#2E �� REGis'rERED Y J N FEE CURREh Y!N <br /> I __.. � <br /> Acidress License# �� <br /> t6 � 1RiQR16l1 'D11l11@11l11AII � iDB11ltl � l ( 1 ➢ EIlIIIM9110t1t1llbl111 # f � 6 ' <br /> RESIDENTIAL Attach(2)Plot Rlans;(2)sets of Building Plans;(1�set of Energy Forms;R-O-W Pesmit for new cons2rucUon, , <br /> � Mlnlrrtum ten{10}wo�king days after submittal date. Required anslte,Constructton Ptans,Starm�rrater P3ans w!Sitt Fence instatted, ' <br /> Sanitary Facilibes&1 dumpster;Site Wark Permit for subdivisions/larye projects ( <br /> CQIttIMERCIAI.- �Atiech(2)compleie sets of Building Plans plus a Life Safety Page;{1)set of Energy Forms.ft-O-W Permit for new construction. <br /> � tvlinimum ten(10}wtsrktng days after submitEal date. Required ottsite,Canstructian Plans,Stormwa#er Plans w/Si1t Fence instatted, ! <br /> I� Sanitary Facilities&1 dumpster.Site Work Permit for aU new proJects.All commercial requirements must meet comptiance i <br /> SIGN PERMlT AtEach(2)sets of Engineerec!Plans. ' <br /> �i "*"`PROPERTY SURVEY required fac a1)NEW construatian. <br /> II <br /> Directtons� � <br /> Fi1i au�eppEicatlort comptefely. , <br /> Owner&Contractor sign back of applicatlon,natarized <br /> tf ovee�$2500,a Notice ot Cammencement Is�equlred. (A!C upgrmdes over�7540} � <br /> ** ?,genfl4(for the contractor}or Power of Attomey(for the owner)would be someane with notarized ietter irom owner autharizing same { <br /> OVER THE COUPITER P�RMlTTING {copy of contract rtquired) ' <br /> Reroafs i#sll Ir�gtes Sewers Service Upgrades AtC Fences(PtoUSurvey/Footage} � <br /> Driveuvays-Not aver Countec if on pubifc roadways..naeds ROW , <br /> l � <br /> i' , <br />