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813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021
<br />� , •- Building Department
<br /> Date Received — ,f'�- Phone Contact for Permlttin S'02 a - �9 ��
<br /> 9 "`
<br /> Owner's Name �(/ /� _ Owner Phone Number
<br /> Owner's Address � Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOBADDRESS �(D �` � C7�'� LOT# �
<br /> suBoivisior� �� ,-,� PARCEL ID# , a? / 0 O U O C�0 02 Z�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE�
<br /> WORK PROPOSED e .. NEW CONSTR B ADD/ALT 0 SIGN Q � Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROP.,OSED�USE Q SFR Q COMM � OTHER :
<br /> TYPE`OF CONSTRUCTION Q BLOCK •- Q FRAME Q STEEL Q �
<br /> � �, �f � �/
<br /> DESCRIPTION OF WORK !Ji �✓�Z�'a"[.L� . �.
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT �
<br /> QBUILDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> �ELECi'RICAL $ �� � , � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br />, QPLUMBING $
<br />' �
<br />, QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION r� l ���
<br /> 4I
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> I FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO .
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<br /> —- --- -- - - - -CORfi PAPlY--- - -
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> - ELECTRI,CIAN ;,.• COMPANY /'L�� �C '
<br /> SIGNATURE �T/L(.��%�GU O��,S REGISTERED Y/ N� FEE'CURRE� Y/N .
<br /> Add�ess aa � - �o - . L• License# "�� , 08 '"���j
<br /> � j=�����r—d.J�
<br /> ,,,, .
<br /> PLUMBER.,.,� , - -COMPANY:' ;-_ - ` �
<br /> •SIGNA7'URE REGISTERED Y.•/�N: ," FEE CURRE� Y/N
<br /> Address Llcen`se#' �
<br /> , , � -
<br /> � :.MECHANICAC' , . . , , COMPANY: - -
<br /> " "SIGNATURE�' • � ' ReGisrEREo , Y/ N , FEE CURRE� Y/N � , .
<br /> ' . • , . � _
<br /> Add�ess-'° ' ' _ � � � L-icens.e# -
<br /> .S.:yt:. ' � ',_. , . .- .. , ,
<br /> _::OTHERT�;:;'.'°: � � ' � �COMPANY . - `
<br /> �%SIGNATURE,�;:•�r, - - - , '. •` � '
<br /> , _ - � REGISTERED Y/_N- � FEE CURRE�' . ` Y./N� ., ,
<br /> �;;;; �„'- , - �,, . . . .. - _ .
<br /> �AddFess_;.. :.r,��.' ._ .y.:.:; �.�c=�`� ' � ' _ License.# ' ,. , _. _ .� ,.
<br /> -.�RESID,ENTIAG;;�r:Attacti:(2,�Flot'Ptans;;;�2:sefs�of`Buildin '�Plans;�1-'set`of�Ene :Forms�R-O-��::Permit:for'.n�ew.construotion . -
<br /> - ), �.) ,. 9 �..) _ r9Y. ... , W. ., .
<br /> r� ;� " �.�� ��-'�Minimum;Ytem(;10.)working;days'afteF;'s',ubinittal>date: Requi'redonsite;°ConstnicGon Plan's;:StormwaterPlans,w/StltFence.installed„ _
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<br /> - __. �- "Sanita,:ry.;Facili8es:&`1�.dumpster'Site�VUo[kReRnit:for;sutid'ivis'ions/large;projects�.. - ' ' - , "" - - '
<br /> ,.�.: ..,:�.-... .,. .- .
<br /> �=�.:.C.OM,MERCIAL= : Attach�(2)corriplete:sets of;Building;Plans,plus a Life Safety.Page;.(1)seYof Energy,:Fomis:R-O-W=Permif_fornew constniction.".
<br /> � - '�,���� �„' Minirrium`ten.(10):wo�king,day;s after:submittal'date. Required onsite,_Construction.P.lans�Stormwate�.Plans;w/Silt Fence;installed„-
<br /> ;� - '�' � ��'- - Sanitary' Facil'itles;8 1`dumpster Site VVo�k P.enriit:fo�"all-new:p'rojects..All.commerciaFrequi�ements-must meet compliance � ' �
<br /> :�1.SIGN:PERMIT '`Attach�,(2)sets of;Enginee�ed Plans:.'�•, � � . - - " ' - ' �
<br /> ' - . .- � """PROPER7'Y SGRGEY;�eGui�ed,for.all�,NEW;construction:� � � ,� � -, - ,
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<br /> �Diiectldns: � _ ' . _
<br /> .- ':�F(Il�out'application.completely:�- , '.; ,: ., , , ,y
<br /> .• . O,wne�'8 Contraator sign.back of application;,notariied•� ' � �
<br /> � '�If;over$2500,'a;Notice of:Commencement i's�required:,-_;.(AIC.upg�ades.over..$7500) ::,; ,
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<br /> �"'�'"_� ,Agenf(for°th`e�contracto�)�or�P,ower'of:Attomey;(for.;ttie"o.vmer).would�tie someone-with_notarized.letter.from.ownerauthorizing.same
<br /> �c.;OVER;THE�COUNTER:PERMI7'TING:'{,`._;:.�(copy'of:contract.required);' `.-'��"'`'�``' � '` � ' , � . - � '� '
<br />�I ;`';Reroofs•if'shingles � =,Sewers-� �;.SeniiceUpgrades._A/C'. Fences:(Flot/Survey/,Footage)= ' .
<br /> _`:-�.,.
<br /> � �=Drlveways-Notiover Counterif.on.putilic roadways:neeclsROW-� ,.
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