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s�a-�go-oozo City of Zephyrhiils Permit Application Fax-813-780-0021
<br /> - Building Department
<br /> Date Received �� '2( �, phone Contact for Permltking ��� �t T — � ,�� !
<br /> ��
<br /> Owner's Nama � ,c7,.� �c..'`. t�r Owner Phane Number
<br /> Owner's Addr� ss � cD S� c Owner Phane Number �— � �
<br /> Fee Simple Titleholder Name Owner Phone�Number �
<br /> � � �,_„ „_
<br /> Fee Sim le Ti�leholder Address
<br /> P
<br /> JOB ADDRE S �7�� I 2 � LOT# [�
<br /> SUBDIViS10 �� � PARCEL ID# 'Z-:Z _ -� � -- ab�o�_ �} 0
<br /> (OBT NED FRdM PROPERTY TAX NOTICE)
<br /> WORK PRQPOSED NEw COt�STR ADDIALT � 31GN Q Q DEMOLISH.
<br /> INSTALL REPAIR
<br /> FROP.OSED SE Q SFR Q COMM C� OTHER
<br /> TYPE OF CO $TRUCTION C] BLOCK • Q FRAME C] STEEL [� _
<br /> DESGRIPTIO OF WQRK � � S�_ G� S" J�`_. �
<br /> BUICDiNG SI E SQ FOOTAGE . HEIGHT C,_.-,,�
<br /> BU�D1NG I���� VAEUATION`OF TOTAI CONSTRUCTtON '
<br /> Q
<br /> ��_C__�:„
<br /> QEL CTRSCAL ($ � AMP SERVICE � PROGRESS ENERGY Q W.Ft.E.G.
<br /> �
<br /> QP�UMBING � �
<br /> �M CHANICAI $ VALUATIQN t7F MECHANIGAL INSTALLATiON t"` � � � � �
<br /> QG S Q� ROOFING Q SS'E£IALTY � OTNEF2
<br /> FINISHED F OOR ELEVATIONS ��� FLOOD ZONE AREA QYES NO
<br /> SUILDE}2 COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �� �
<br /> ELEC.TRiCI, ' ✓ CQMPANY .... ,
<br /> SIGNATURE ^. ,� REGISTEREp. Y/ N �� �FEE CURRE� Y/N
<br /> Addres Cicense# �— { ��
<br /> PLUMBER. COMPAF1l'- �
<br /> SIGNATURE •REGISTERED Y�/ N ' ` FEE CURRE� ` Y/N
<br /> ° Addres � ' Cioense#'�_ �
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<br /> ; MECNi4NIC � , COt�lPANY =
<br /> � SIGNATURE REGISTERED - +�; .Y/.N FEE CURRE� � Y/N
<br /> Addres - `" - Licens.e.#.�� ��
<br /> OTtiER`'=' �. t� GOMPANY �1 .
<br /> SIGNATUR :� ����L�.-�� REGISTERED Y/.N: FEE CURRE�' N. •
<br /> .., /
<br /> Addres �7�� 5 2�--v� License# ��.C—� � ����.�
<br /> � , - . �, ,
<br /> ,'.RESIDENTI _;. Attacfi•{2};PtCif=F?lans;�(2):sets af�Buililing'�F'lans;°(1}se#`of Energy,Form's;12-Q,W'Pertriit,for new canstnac6on,
<br /> ��;_;; ,a, ;Minimum.ten'(:10):working:days aftec submittal•'date. Required onsite,Constniction Plans,Stormwate�Plans w/Silt Fence installed,
<br /> Sanita,.ry.;Fac�lities�&14�,dumpster;Site Work`Perriiit for,subdi'visian`s!large.projects • ` �
<br /> v=COMMERC4 Attach�(2)'comptete sefs of Suilcling Plans ptus a Life Safety Page;(1)set af Energy Fartrts.R-O W Permit for new canstruction.
<br /> - : � Minimum#en(10)working days after submittal date. Required onsite,Ganstruction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Fac'slities&1 dumpster.Site Work Permit fa�al!new projects.Aii comrrtercia!requirements must meet comptiance
<br /> '-StGN PERM,T Attac}i(2)�seEs of,Enginesred Plans:,.. -
<br /> , ""*"PROPERTY SURVEY_required for.aII.NEW..construction..
<br /> Direotions� ,� _. �� �
<br /> - Fill.out pplication completely.
<br /> � Owner&'Contractor s�gn:back af application,nata�ized
<br /> If over$!2500;a Notice af Commencement is required. (A!C upgrades over$7500)
<br /> "` Agent((or the�cb�nt''ractor)or Powerof Ai#o"mey(for tfie awaer)would be someane with notarized letter ftom owner authorizing same
<br /> I �
<br /> :,OVER7HE'COUNTER;PERMfT-TING (copyof-contrac6required)
<br /> ^:Reroofs if sh�ngles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drivew ys-Not ove�Counter if on public roacJways..needs ROVV , ""�� ' � �`m��='�`�'�'�T'��������*p�� ��
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<br /> ; '«'ff-�t'Cir-t.Ze�:+�•c'�.i:tir. ,'e:.. 2`... ... •• �i i ..c � ,.« .....Y.tenar .rn,a..,b0-as-.,".:��TM.�?c�.n�.
<br /> ��£54+..N.tt.•rIPM":+l��>+h*�XSe!.•eec..a,.:_ ....:..1�'�'r. '. .,- t.r.
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