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a�' �ao-oozo City of Zephyrhilis Permit Application Fax 813-780-0021
<br /> Building Departrnent
<br /> Date Recelv� d �� � ; phone�Contact�for�Permittin ' ` 3 ( _ ��(1 � '
<br /> Owner's Na� e '�' �(� �G7,�,(�rn(,f,1''.� pwner Phone Number (�l�J` �'� `���S
<br /> Owner's Ad I ress �lQ�{� PL'.�'l GI�Q'�" V-[:w�C�- • Owner Phone Number
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<br /> Fee Slmple I Itleholder.Name � Owner Phone Idumber �
<br /> ,,-1
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<br /> Fee Simple I INeholder Address �
<br /> JOB ADDRE�I s �P�3 P(�X���-�- L6W l� Z e-� Y�t.l,t� �'� 33�� LOT# aa�-P
<br /> SUBDIVISION l �� I Y\.� PARCEL ID# ��'o�+'" °�� `����•'�.�� `a'c��l�
<br /> I �- , (OBTAINED FROM PROPERTYTAX NOTICE)
<br /> WORK PRO �IOSED , • NEW CONSTR ADD/ALT Q` SIGN 'Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSEDf.II SE SFR Q COMM Q OTHER
<br /> TYPE OF CO STRUCTION Q BLOCK '" 'Q FRAME Q 'STEEL � y,�
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<br /> DESCRIPTIO� OF WORK' � I� �
<br /> � / at'-��
<br /> BUILDING'S12E ' �`-f�� 7� SQ'FOOTAGE �7—/ HEIGHT ,
<br /> QBUII DING $ VALUATION`OF TOTAL CONSTRUCTION
<br /> I , a ��O � � '
<br /> QEL CTRICAL $ ��� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> II ��� .
<br /> QPLU BING $ ��;�r� - � ��O� 1�
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<br /> QME HANICAL $ �C�` � VACUATION OF:MECHANICAL INSl'ALLATION r��
<br /> II .�U� �
<br /> QGA Q ROOFING .Q SPECIALTY Q OTHER• /� Q�
<br /> FINISHED FL II OR ELEVATIONS FLOOD ZONE AREA QYES ;,NO �
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<br /> BUILDER I i COMPANY'� ��
<br /> SIGNATURE II � REGISTERED Y/ N Fee CURttEn Y/N�
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<br /> � Address I, , Cicense# -� C�
<br /> ELECTRICIANi ts-i.� �l�- �� F COMPANY ' b��
<br /> SIGNATURE 'I � � REGISTERED Y/ N FEE CURRE� � Y/N
<br /> Address � J� L�r � ;� .. � . ��3���, License# .
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<br /> PLUMBER ` _ � � � COMP.ANY � '
<br /> SIGNATURE I V , REGISTERED - Y./:N' ,�FEE CURRE� " Y/N. •
<br /> Address I � License# � � � � �V'
<br /> MECHANICAL' II '�u .. �� COMPANY ' ��� '�n�.8_ .
<br /> SIGNATURE i REGISTERED Y,/ N � _ ; �Ecuw3en Y,/,N
<br /> Address��I�:` ; ' - ,'�'�� , � � Z - �„ �,��'v License# , �
<br /> OTHER • - � •- ;COMPANY_ , ,
<br /> ' � - ' ' E RREh Y/N
<br /> SIGNATU
<br /> RE � � - � REGISTERED Y/
<br /> N . FECU
<br /> Addres�� • License#�
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<br /> RESIDENTIAL:,;�. :AttacFi'(2);Plot:P,lan`s;:(2)sets:of�Buil'dingi Plans;(1)'sef ofi Energy�Fortns;�R=O-W'Pemilt for new construction,
<br /> , Minimum�teg�(1.0):,worlcing;days�after�subrr"miftal'date.��.Requlred onsife,:Constnictlon:Plens;Stormwate�`Plans w%Sflt Fence installed,
<br /> `"�� �Sanitary Facflldes:&=.1•;dumpster=Site°Work.P.;ermit for subtli4i51ons/large projects . '"':'-- _ •� ' .
<br /> --��4!!u!E�FlGlAS..-�—AtLc.h{3)c.emRlete-se�-'�f-�3i!Io�J(Ra'Plaiis-plusa�.!€t+_�fp�,j:F±��Prl=1)sOt-�sf�ner�N-FQ!mcrR-��IY-P-@rtYllt-fOCAHW-[X�nStRA4't6�. -
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides 81 dumpster.Site Woek Permit for all naw:�proJects..All commerolal requirements,must meet compliance
<br /> SIGN PERMIT 'I AttacFi(2)'"sets of Engirieer.ed„P:,lans:.,:- ;�-�� ;
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<br /> "••PROPERTY SURVEY required,for all NEW constructlon.._
<br /> Dlrectlons: I � F_° ,, '�„ , ,
<br /> FIII out appl cadon completely.
<br /> Owner 8 �ntractor sign back of applicaUon,notarized
<br /> If over�25 0,a Notice.of Commencement is requlred. (AIC upgrades over ST500)
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<br /> Agent(for I e contractor)'or Power of Attoriiey=(for tFie owner)would be someone with notarized letter from owner authorizing same
<br /> �VER THE COU TER P..ERMIT.TING�- �-- �(Front of-Application Only)� - "
<br /> Reroofsifshingl�s• --�--Sewers•--••-- Service-Upgrades A/C Fences(PIoUSurvey/Footage)
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<br /> , Drivewaya- ot�over Counter,if on public roadways..needs ROW ���``��:-'%=� ..�. �'� ���'� , .., •
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