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813-780-0020 Fax 813-780-0021
<br /> � City of Zephyrhiils Permit Application
<br /> . Bullding Department
<br /> � L
<br /> Date Receivei �� Z�, / :•. Phone�Contact'foeParmlHin � �� � �o — � � �
<br /> Owner'a Namile 0�"'�d� M�� �h h Owner Phone Number ���' C��G � �S�a'
<br /> Owner's Addreas ( � � �"�� ;S^� Owner Ph'one.Number�
<br /> Fee Simple T(tleNolder.Name Y 5�����h A�l�(.�a�°j ' � � Owner Phone Numb�r -
<br /> �,$ . -
<br /> Fee Simple Itleholder Address -
<br /> JOB ADDRESS �i��� �� Z-e Qh �r��1 I S, ��. �or# �
<br /> SUBDIVISIO � . . PI4RCEL ID# � - � ,
<br /> (OBTAINED F.ROM.PROPERTY,TAX NOTICE)
<br /> WORK PROPOSED .�;NEW CONSTR AD�/ALT �]� SIGN' "Q �Q DEMOI:ISH
<br /> ,__, �., INSTALL � REPi41R '
<br /> PROPOSED:.U$E , - � SFR. Q. COMM �. Q •OTHER = � �
<br /> TYPE OF CO I STRUCTION'- Q" 'BLOCK + Q FRAME � .[� STEEL' `Q � �
<br /> I - ^� I � . ,
<br /> DESCRIPTIO OF WORK` WOoCDt� �C h t y,Qh h�( .{'�� �'•���• fr��cc� v�. �,�7 Q �5-
<br /> BUILDINGSIZE' � � - � 'SQ'FOOTAGE��, ,HEIGHT� �,
<br /> QBUILDING $ VALUATION�OF'TOTAt-COySTRUCTION^1 '
<br /> � n �-`z � . . -
<br /> QELECTRICAL $ - AMP SERVICE. >Q' �PROGRESS ENERGY Q W.R.E.C.
<br /> QPL IMBING , : $ ' . �
<br /> �I � . ,� �b3 ,
<br /> QMECHANI6AL' , $ '" ' �'VALUATION OF;MECHANI,CAL INSTALLATION. -(�� I
<br /> ;.. . ; ,,.,.,. �,� , L
<br /> [��f Q ROOFING ,Q, � SPECIAI,7'Y:C];�: :..OTJiER, �, ,.
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA „QY�S. ,NO
<br /> I .., .: . - :,. .. . _ ° .. ,
<br /> s,,.r - ..s�.r.,,.�� �r .�;..
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<br /> BUILDER S�^ - COMPANY�` ,.< ` -�i�'ti0'V=��� • .Q��:�e�!'=,. � �
<br /> SIGNATURE REGISTERED Y/ N . ��=!FEE CURRE�: '` Y`/N' '- ' ,
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<br /> Address �� :�� s.:,. . . -•� .. , •Llcense:#� ,,' • ,
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<br /> ELECTRICt - '` , ,., .. - ,, , ;a.':�< ,:_�,.: - ' ;,, . - .. . , , , !
<br /> . CONIPANY =:�
<br /> SIGNATURE�� � REGISTERED xY/ N +FEE. � , ' '
<br /> 'CURRE�'%i ' r ;•*Y/.N° _ �
<br /> Address ' _ � ,. ' ' _ , - , • _` .�r .. � i�;�1>:License;#�� . , . . - .. '
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<br /> PLUMBER ,�,` -. ' . , . ,C.OAAPANY . , _ `'. , .,, - ,,,; . - . , ��
<br /> SIGNATURE� '4i ;� . � . � .. �• . �, `REGI3T.ERED ",;Y,/,N;a .�,�FEE�CURRE�;L. _,Y-/.N,.- -
<br /> � - - • , . . _ ,_ _ .� ,
<br /> Addre�s'� ... � • ,, � . ,. �'Ucense�#,, . . _ .. - . ,
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<br />' •MECHANIC '� „-".. s , ., - � � COMPANY � ti:_ - ,> ;3-. . .
<br /> SIGNATURE.� ,:� i}>.,,,.. •. :.. . , • ,. - ,- .;,.; � :�< � ,_ .... _. „, , .. I
<br /> RE�ISTERED >. Y/,N `��FEE�CURRE�.., 'Y./��N:_�,.
<br /> _�I ...T: - -r. . .. .. ,..;��
<br /> Addresa: ,. ,;=.', ,. . ,.:�'•; , ,. .. .��x , _ , ., � , , ,., -. ,;., • i .. �, , . , . , -
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<br /> �.License# ,
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<br /> _ - : , , .. .. � - ..., . . , �, -. .,, _ _ Y:Y-� ^}
<br /> OTHER �` , ,- ., ... _ , , .. __ ., � _ ,�_:-, . , � . �:,.; ; -,, , .
<br /> ,COMPANY - _ .
<br /> SIGNATURE�: _.. - �;� .� �, .. . _:x..,•:{ .. . , , .r�, . _. . ._.. _ .,
<br /> 'REGISTERED� Y/'N_..� ;FEE'CURRE�' Y7 N
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<br /> 'rF!Sr �� .L.. . . ... .. . ... . .. .. .. - _. `,
<br /> �4cldra�� Ft,Ri. �}:.awy ''eC�'�n'("; ',SJ.���`:� _�:°ry'"1 .L:, ,':�`'.-': . L'Wnselr�' .� � ` . ^ _ - .i'
<br /> �RESIDENTI�. , '.'�,A � , ;� ,...._ ,���, �,,.,.�,:,.. .. . .,.. j,�:y ,;;.,:;" ::,,.� .:., ,. _ ,
<br /> ttach:.2;Plot�_P..lens``�(2)sefs�of;Bn�IdingiPlans;�(!�) i �, '���F:`,�-
<br /> �.(.) , setiof`Energy,Fo'rtns;R=0-1N�Permit'#or`-newaco'n§tnictlon,..
<br /> -���u�;��.Mtnimumeten;(1,0)�worl4ing,d�ys�aiter;submiftal:daf."e."-:aR;equlred onslfe;:Constiuctlon'?lans;S4orenwater-Rian's�w/Sflt Fence�lnstalled, '
<br /> Sanita'ry Fadlides;&�1;dumpster�,Site�Work Pertnif,fot;sutiifiVtslons/la e; rnj � - - -
<br /> „ _ _
<br /> -I __ . ,--- �:.. ;,.:._, , - r -� �.s< ,
<br /> � .,�_..:..�.E. • . av . �9._=P.. eCts';�;;�;:��s'�<.� :--�,.,,•..t:
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<br /> � { , . ,.�,-:;• .� ...... . , _,,,.,:, ,:�r,= ... x. ,_;..�z:;y�`: _ . .�:�.�_._ -
<br /> COMINERCIA� Attach(3)°eori►plete�sets of�Bulldfrig Plans plus"a Life S`afety Page;(1)set of Energy Forms.R 0-W Permit for new..constiuction.- � �
<br /> {Vlinimum ten(10)working days after submlthal date. Required onsite,ConsWction Plans,S4ormwater Plans w/Silt Fence installed,
<br /> . Sanitary Faclifdes 8 1 dumpster.Site Work Permit for all new�projects::All commerctal resaulrements_must meet campliance` � � ' "
<br />, SIGN PERMITI AttacFi'(2)'sets of"Eng,l"neered%Plans:,�;.��.�:,°:�;r; ..::�:s. :,,�:.�,:. , � , -. . - �: • . -'
<br /> ..
<br /> "'•PROPERTY SURVEY required for all NEW_constructlon._ _. •
<br /> � - - -� _ -
<br /> �DI�ecNon�: •-:����+!..,��„.�.:_ -. �� -
<br /> Ftll out ap�licadon completely. �
<br /> Owner&Contractor sign back.of appllcaUon,notarizad i
<br /> If over�2500,a Nottce,of Commencement la rsqulred. (AlC upgredes over a7500) �
<br /> I :.:c::=;>_'����°,�:���'� ' � -
<br />' N . _ _.�._ .- �
<br /> Agent(fo I the contractor)'or"Powe�`of Attomey(for the owner)would be someone wlth notarized letter from owner authodzing same �
<br /> DVERTHE:COUNTER.PERMITfING-�--•�-;-•(Front�of•AppliceUon�Only) -�--- - �"- " � , .
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fances(Plot/Survey/Footage)
<br /> i.'si:l"..,. � ..-. - . � ..'�i, v-':'.pi!_
<br /> Delvewayl-Not over Counter if on public roaduvays..needs ROW' ' � � �
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