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s�s-7so-ooZo Gity of Zephyrhiil� Permit Rpplicatipn Fax 813-780-OQ21
<br /> , ' Bullding Department
<br /> Date Recelved phone�Gaatacttor•Permittfn `
<br /> Owner's Name V �'� � � � ��J � Owner Phane Number rJ � ��, Z � Q ���
<br /> Owner's Address �C� � �} ��-�� ��Y A��'' � Owner Phane Number
<br /> Fee Simple Titleholder Name � � Owner Phone Number 1 �
<br /> ,r •
<br /> Fee Sfmple Titl�hotder Address
<br /> }�, .- �
<br /> JOB ADDRESS �'�( '� �� LOT#
<br /> SUBDIVIS�ON � � ' PARCEL-ID#
<br /> - , (OBTAINEB FROM PROPERTYTAX NOTICE)
<br /> WORKPROF{3SED NEwC8i3STR ADD/A�T [� 81t3N 'Q [� DEMOLiSH '
<br /> ��,�INSTAL� � REPAlR
<br /> PROPOSED:USE �rSFR Q CQMM' [[� OTHER
<br /> TYPE OF CONSTRUGTIQN" Q BLOGK ' Q FRAME � STEEI. "Q
<br /> DESCRIPT10N OF WQRK- - . l— L �L '"� �I�� I� � � �
<br /> BUILDING St�E` �����"SQ fOOTAGE ,HEI,GHT�.��„�,�
<br /> QBt!lLQING $ �R �� CJ VALUATION QF`TOTAL CONSTRIJCTIdN
<br /> V
<br /> QECECTRICAL - �—.� AMP SERVICE Q PROGF2ESS ENEi2GY Q W:R.E.C.
<br /> QF'LUMBlNG � � �
<br /> MECHANICAL �� V ��
<br /> Q $ VALUATlQN QF MECHANlGAI IIVS7ALtATiON `� �
<br /> �,]GAS Q ROOFING Q SPECIALTY Q UTMER '
<br /> FINISHED FLOOR ELEVATIOIdS �� Fl.00Q ZONE AREA QYES ,NO
<br /> BUILDER � GOiUlPANY=•. - ��,3� L � W� �Cl _
<br /> SIGNATURE ��4�G7"�.� REGlS7ERED Y/ PI FEE CURREA Y i N` .
<br /> Address - ,;4:W, , ;,} l'Jcense�#�l , ' ' �
<br /> ELEGTFtiC1AP1. - � '�OMPANY , •, ', � . , .� � ' .
<br /> SIGNATURE ' REGISTERED Y! tN FEE CURREh�= �-�Y l id
<br /> Address� ' s � � ,_ , . License-,#;I � �". ��
<br /> PL.UMBER � COMP,ANY . :• . . , , �:: ; :
<br /> SIGNATURE` ' � RE�i5r�iiEn Y./..N:; ;,: �FEe:cu�-, �Y•!N. .
<br /> Address � ,..License�# I- .:.=.. - . -_` �� -
<br /> MECNANICAl: �� � . COMPANY; ' 4 , .
<br /> SIGNATURE - ' " ' ' ,REGts7EiiEQ Y./_N . , FEECURREh<, . Y'/�N
<br /> Addre�s`'-, , . � ,.. , ` - ' .License# i ..... .. . . . �
<br /> �: - --_ _ ,
<br /> OTNER ,. :;'. ; ' . . , �GOMPANY M1 `;: , ,
<br /> SIGNA7URE ' ' �� - ' � = � � " � "REGISTERED� • r � Y/ N.. � _FEE CURREl+ Y/N ,
<br /> Addrass " -• . _ . .. ' Ucense# t ' I �
<br /> �.. � .. �r.;.; . .,: .._ ..x .... . ,_. a : - a .
<br /> REStDENTIAI:° A�taah"'(2};plot�P,lans;:(2)sets:'of'Buitding Flar�"s;(1)set oF�Energy°Foims��R-0-1fV�Pezinit for new coastruction,
<br /> , ;.,:Minimum;ten,�(1.0):working;days�afte�,;subrimf.ttal'date:::Required onsite,:ConstrucBon=Plans;'Starmwate'r'Plans w/811t Fence installeii,
<br /> �� <Sanifary�Facilities=&R1r,dumpste,r,;8ite°WorkrParmittor,subiiivisionsilaige;projects;_4:�°:;, ` " ` � `
<br /> COMMEFtClAL Attach(3)�coinplete sets`of Bufliffng Piaris plus a'Cife Saf�+ty Page,•'('f}set of Energy Fortns.R-O-W Permit for new construc�ti6n.
<br /> Mintmum ten(10)working days�aftar submittal date. Requlred onsite,Construcdon Plans,Stormwater Plans w!Sllt Fence tnstalled,
<br /> San(tary Facilitles&1 dumpster.Si#e.Work Permik for ali new�projects..Aii commerclal requlrements.must meet campllance
<br /> SIGM PERMlT Attach'(2)ssts of Eiiglrieeiad:Pians:�; � r� ` .. .. � �
<br /> "••PROPERTY SURVEY requlreci for all NEW�canstruction.. , -
<br /> Dtraattons: °-..` .�=;�- . ,
<br /> F(II out appltcaUon completely.
<br /> Owner 8 Contractor sign back of appllcaUon,noNarized
<br /> if over S2S00,a Elotice of Commencemenf Is required. (A!C apgrades over�7500)
<br /> '• Agent(far the contraator}or Piswer of Attotne}r(for ftie awner}�would be someane with notarized ietter fram owner authorizin�same
<br /> -:: t:. =
<br /> DVER THE GQttNTER PERMFfTlHG (Front af-APPlication-Onty)- - . - `. � •- - -' . " . - ' '.
<br /> Reroafs if shingles Sewers ServEce Upgrades AlC . , Fences.{PlotlSurveylFoatage} , ' � ° '
<br /> Drirrewaya-Not over Counter if an public roadweys.,needs RCiW:' ' ' ' " � ` .
<br /> � ' ,. � ,� , .. __. __� � .. .. .> . ,. . �,-��`
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