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813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021
<br /> • Building Department
<br /> Date Received ' g�� �8� _ ��t�
<br /> Phone Contact for Permitting •
<br /> Owner's Nam I ��Ct,�i"'' e� �l�-1 l(�� � Owner Phone Number UL�' �Jr
<br /> Owner's Addrl ss � / /�� /V� . O�7J �l� Owner Phone Number
<br /> Fee Simple Tit eholder Name Owner Phone Number
<br /> Fee Simple Ti I leholder Address
<br /> I JOB ADDRESI �/��U �G� D�'1 J �JC LOT# �
<br /> SUBDIVISION � (�1� j'lZl) PARCEL ID# � �� �� Ll(✓ ���� ��
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROP��SED B . NEW CONSTR� ADD/ALT 0 SIGN Q � Q DEMOLISH
<br /> � INSTALL REPAIR
<br /> �
<br /> PROROSED ISE Q SFR Q COMM 0 OTHER
<br /> TYPE OF CO STRUCTION Q BLOCK • Q FRAME 0 STEEL Q
<br /> DESCRIPTIO OF WORK ��5,: �/�. �I��/� L `-QLL� ` � �D/�/ �Y!'1 �IP./IP`�
<br /> BUILDING SI E SQ FOOTAGE HEIGHT
<br /> �BUII DING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> QEL ICTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> - I
<br /> QPL IMBING $
<br /> QMEI�HANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> � 9-l�q�', a�
<br /> QGAI Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FL� OR ELEVATIONS FLOOD ZONE AREA QYE8 NO
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<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# � �
<br />�� ELECTRICI COMPANY
<br /> SIGNATURE i REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addressl License# r
<br /> PLUMBER.: � COMPANY
<br /> SIGNATURE �REGISTERED Y/ N FEE CURRE� ' Y/N '
<br /> � �
<br /> . Addressl License# - I
<br /> MECHANICA4 ' � , .���'yj,` �� , COMPANY ��S '�'�G1/{/
<br /> SIGNATURE ���'� REGISTERED Y/ N FE CURRE� Y/N
<br /> Address� �- '��'� ! � `� License# C./T�� �r3��� l i
<br /> ;��, � i .. _
<br /> OTHER � COMPANY
<br /> SIGNATURE- � REGISTERED Y/.N FEE CURREA Y./N
<br /> Address�. � _ , - - License#
<br /> RESIDENTIAI�. :. Attach:(2)Plot'P,lans;�{2)�sets of�Buildirig=Plans;(1)'set'of Energy For'ms;R-O,W,Permitfor new.construotion,
<br /> _ Minimum.:ten=(�10)working•d'ays aftersubmittal.date. 'Required onsite,"Constriiction Plans,Stormuvater Plans w/Silt Fence installed,
<br /> � � Sanita,ry Facilities.:8 1s.dumpster;Site;W.ork Permit for subd'ivisionsRarge=projects
<br /> COMMERCI Attach(2)complete`sets of Building Plans plus a Life 3afety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> IMinimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> �= Sanitary Facilitles 8 1 dumpster.Site Work Permit fo�all new projects.All commercial requirements must meet compliance
<br /> SIGN�PERMI Attach(2)sets of;Engineered Plans. - _
<br /> . � ""'*PROPERTY SURVEY required for aII,NEW construction.
<br /> `Directions: ' � > • , , • - -
<br /> � Fill out a plication completely.
<br /> O.wner&�iConVactor sign back of application,notarized
<br /> „ If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500)
<br /> " Agent(fo the confractor)or Power ofAttomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE CI� UNTEF�P TT (��p�/�Q • 4 /�1�1 ,,.1) - - ���"1�""�''�`""�y
<br /> v�.�'�' �.M�>iwJ��3tiSMn�G���k�QF�lx�rC,y' •`�� ,vusq,�.
<br /> � Reroofs if shingles ,�Sewersaa��;•���Se�viae,'�P9rades,p.JG�,�1,,. F;ences(PIoUSurvey/F tage)���3�°;� r�A'`�.�Y� 4 `.,,;-=-`-,. �
<br /> �i '"!}'2:�i'�U aSE.fL' :t'iil�'��1�,..u�� �o�.=r,.`t, �. . �.�lN7��'�'i57a Cu?=tti"�i'i.1��. ,is�'•'a,' ri
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