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o„-,a�-���U ciry of Zephyrhilis Permit Appticatian Fax-813-�80-0821 <br /> Buiiding Depafinent <br /> I <br /> Date Received �j � � phone Contaat for Perntitting . a� y.�.3 "' - .�''�7 <br /> Owner's Name �C'� �� �, ���� Owner Fhone Number '7a.5�; �3'�Z� -3�ti�/'7 <br /> Owner's Address <br /> (���1 l, 1!1/I � L F? � 1-��r �� Owmer Phone Number <br /> F�e Simple Tltleholder Neme � � Owner Phane Number <br /> � <br /> � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS <br /> 5 y, L E P�! N 0��-o+n�/ �P�}R 1 6 6 I b � 3� �= � �.oT# �D <br /> S!lBD1VIStON � ��� . � PARCEI.ID# � <br /> (08TAINED FROM PROPBltTY TAX NOTlCE) <br /> WORK PROPOS � NEW CONSTR 8 ADDlALT r"� SIGN � [� DEMO�ISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM [,� OTHER <br /> TYPE OF CONSTRUCTION [� BLOCK' Q FRAME Q] S7EEL Q <br /> DESCRtPTiCiN O WORK �•�" u� ��b� ,'� � �� '� <br /> Btl1l.DlNCa S1ZE ��� SQ POClTAt3E�� t1EiGHT � � <br /> �i <br /> QBUILDI�G $ J� �t ,�1 VAtUAT10N OF 70TAL GONSTRt?CTtON <br /> QELECtRICAL $ AMP SERVICE �) PROGRESS ENERGY [� W.R.E.C. <br /> QPLUMB NG ($� �I ���+.5���7�"� �H� <br /> L�. � <br /> �MECHANICAL ($ ��� VALUATION OF MECHANICAL INSTALLATION ��/ �J�� ! <br /> � f -l kr <br /> QGAS Q ROOFING Q SPECIALTY �� OTHER <br /> =1NISHED FLOO� ELEVATIONS FLOOb ZONE AREA QYES NO <br /> �,��� <br /> t�=ez-'3c+�'•'_��`e-�`_`"�..._ � <br /> � �ui�.oEa �j �� COMPANY �d�Q.� ���'►2 r�e�- <br /> SIGNATIIRE � REGIST'EREp Y/ N FEE GURRE� Y/N <br /> � Add�ess � [.ficense#-�� �� <br /> I <br /> =_LECTRICIAN � COMPANY <br /> 3tGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � llcense# � � � <br /> i �LUMBER � CdMPANY <br /> 31GNATURE � REGISTEREO Y/ N FEE GURRE� Y/N <br /> Address - Lloense# �— �^� <br /> �EC�iANICAL COMPANIf � <br /> 31GNATttRE REGiSTERED Y/ h( fiEE GURREi� Y/N <br /> Address License# � � <br /> 3THER CQMPANY <br /> 41GNATURE REG�sTERED � Y! N FEE CURRER Y/N <br /> Address Uaense# � � <br /> tESED6NT1Al. I Attach{2)Plot Ptans;{2}se#s of BuitdEng Plans;(1}set of Energy Forms;R-O-W Permlt far new construction, <br /> �' Mlnimum ten(10}working days after submfttaf date. Requlred onsite,Constructlon Piar�s,Stormwater Plans wt Sflt Fence lnstalled, <br /> 8anitary Faclfltles 81 dumpster,Site Work Permft for subdlvlsiansAarge proJects <br /> :dMMERCtAt �. Attach(3)camptete sets of Buitding Ptans plus a Life Safety Page;(ij set of Energy Forms.R-O-W Permit for new constructlon. <br /> Minimum ten{10)warking days a�ter snbmittai da#e. Regalred ons3te,Constntction Plans,Stonnwater Pians w!S11t Fence instatted, <br /> � Sanftary Facpities 81 dumpster.Site Work Permlt far all new proJeots.Ail commerclal rsquirernents must meet compUance <br /> �IGN PERMIT E Attach(2}sets of Engtneered Plans. <br /> """PROPERTY SURVEY requited for a11 NEW co�strucNon. <br /> , iirectlons: `I <br /> FIII out appll�cation completely. <br /> Ovmer&Contractor sfgn back of appllcaHon,nokarized <br /> If over�2500,a Natice of Commencement is requlred. (AUC upgrades over�7500) <br /> ' Agent(for thji contractor)ar Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> IVER THE COUNTER PERMIITING (Front of Appilca�on Only) ,,.....,y�.�,....y„...:�.��s::..�,:�:.:,.-:,.�_���;.�.>...-�_...,. <br /> ,eroofs if shingles Sewers Service Upgradas A/C Fences(Piot/Survey/Footage} .�::-'�; r -- � -'= �"'`.;� �,, • ^'d <br /> i �, �.l^:.I'K::l,v .ii•t:'.i��iii�\::� •.`� <br /> Driveways-I ot over Counter if on publtc roadways..needs ROW e ,.:�a,i'�+if"-''1'�. f"'�"= _�',�� <br /> � C �i_. . _ �':.„ , L ..s`'r1-` :�t.:`�'' "' <br /> ��''�C:4:., ir..'e.�" ,.: <br /> F..a-r-se»..Mre:y.++a....rucn�. r. �.r. ....:�,.. _ ,...^r:...n..<<1 <br />