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a�s.7 o-oozo City af Zephyrhiils Permit Appiication Fax 813-78Q-0021 <br /> � .. <br /> ' : � Building Deparkment <br /> Date Received Phane Contact far Permitting • -- <br /> Owner's Nam �Q(.�� r �� ( /� Owner Phane Number <br /> Owner"s Addr ss �� �' Owner Phone Number �! � <br /> Fee Simple 7i leholder Name Owner Phone Number � � <br /> Fee Simple Ti leholder Address <br /> JOB ADDRES / �� �t� �oT# �� <br /> SU6C►IVISiON E}C{ �� r �, PARCEL tD# <br /> (OBTAIPlHD FROM PROPERTY TAX NOTICE) <br /> W4RK PROP SED e L NSTALLS�R 8 �°REPAIR � S1GN Q Q DEMO�{SH <br /> PR4POSED. SE Q SFR Q COMM � QTHER <br /> TYPE'OF CO STRUCTION Q BLOCK • Q FRAME [� STEEL Q <br /> DESGRIPTION OF WORK � t 1 �� I''�� p"" ���� <br /> BU1lDING 51 E � � S�'FOQTAGE b� HEIGHT C�� <br /> QBUI DING ����� �,,-�,-1 I �/ALUATtOtV`QF TOTAL C{?NSTRUCTtON <br /> �r�� ,vv� <br /> QEL CTRICAL $ AMP SEl2VICE Q PROGRESS ENEE2GY Q W.F2.E.G. <br /> �,� <br /> QP� MBiNG � � <br /> k <br /> QME NAN4CA� �$!' � VALUATIQN OF lviECHANtCAL{NSTALLATiQN <br /> � <br /> QGA � F200FlNG Q SPECiA�TY C� OTHER <br /> FINISHED FL OR ELEVATIONS ��� FLOOD ZONE AREA DYES NO <br /> BUiI.DER C08APANY �, x JICe <br /> SIGNAITURE �. REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres� License# �� � <br /> ELEGTRi,CI COMPAFlY <br /> SIGNATURE REGI5TEREq Y/ N FEE CURRE� Y/N <br /> Addres Cicense# �� ' � <br /> PLUMBER,; , GOMPANY <br /> SIGNATURE - REGISTERED Y�/ N FEE CURRE� Y/N <br /> . Addres ' License# � � <br /> r. � <br /> MECHANlC CQMPANY <br /> SIGNATURE' REGISTEREp Y/ N FEE CURRE� � Y/N <br /> Acldres � L-icense# �- �� <br /> h:,.�%. • <br /> OTHER. .,'� - CQMPANY � <br /> SIGNATURE:. �-� REG�sTeRe� Y/.N FEE CURRE�' Y./N <br /> Addres _ . � _ �License# � � <br /> '�REStDEN'T! - _ Rttac6{2};P1of Ftans;{2}.'sets of Buitding�Pians;{1}set�of Energy Forins;R-O-W:Permit.far new.canshuctian,. <br /> ,, ,,>,y Minimum:ten.(,10)wo�king;tlays aftecsubmittal�date. Required 'ansite;Construction Plans,Stormwater Plans w/Silt Fence instailed, - <br /> � Sanitary;F.acilities:&!;1..dumpster.;Sife: .W,ock'Permit for sutidivasions/large projects <br /> ;:.GOMMERG! Attach�(2)complete'sets of BuEli3ing Plans plus a Life Safety Page;{1)sef af Energy Forms.R-O-W Permit far new canstruction. <br /> _ Minimum#en(10)working days after submittal date. Required ansite,Canstruction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facititiss&1 dumpster.Site Work Permit fot•ali new projects.Aii commerciai reguirements must meet compliance <br /> ."�SIGN`PERMI Attach(2}sets af:Engineered Plans.` - <br /> " """"PROPERTY_SURVEY required for..aII,NEW consVuction. <br /> Directians: ,; . <br /> Fill out pplication completely. <br /> _ Oumer Cantractar s9gn back of application,notarized <br /> If.over 2500,a Notice af Commencemenf is required. (AIC upgrades over$7500) <br /> �_`* Agent{farttie�contjractoc)orPower ofAttomey(for the awner)would be someone with notarized letter from owner authorizing same <br /> :OVER.THE �OUNTER=PERMITTINCti (copy of-contract required) <br /> ,Reroafs if.shi�gles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> ' DFivew ys-Not over Counter if on pubiic roadways..rieeds ROW � <br />