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s�s-r$o-ao2o C�ty ofi Zephyrhiils Permit Appiication Fax-813-780-0021
<br /> ' � ,�,# • � 8utlding Department
<br /> ` Date Recelved ,Fhonei Contact far Permitting _
<br /> Owner's Name � � �� � Owner Phone Number , �!/ � -4/ �
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<br /> Owner's Address (/ �� ��f�' �- Owner'Phane Numb�r
<br /> i Fee Simpte Titteholder Name � � Owner Phone Number �� �
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<br /> �� Fee Simple Titleholder Address
<br /> Y ��� JOB ADDRESS 1 1 U� I'� � LbT#
<br /> � SUSD1VfS10N �j� !�G tOl/'e . � PARCEL ID#�l �" � _ �!-�Y�� 0 ` ��
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED � . NEW CONSTR ADD/ALT ��' SIGN [� Q DEMOLISH
<br /> e IiVSTALL 8 REPAIR � � r
<br /> PROP,OSED USE Q SFR Q COIViM � OTHER ' � � p�
<br /> � TYPE'OF CONSTRUCTIQN Q BLOCK • Q FRAME [� STEE� Q
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<br /> dESCRiPTiON OF WORK � � (� f/ 1�/?tt `�j n� / (i� /I,�t,
<br /> BUILL}ING"SIZE 3Q FOOTAGE O�� !{ElGHT :C
<br /> ' QBUILDING �`_y� VAlUAT10N°OF 70TAL GONSTRUCTICJN
<br /> [�ELECl'RICAL ��M� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C,
<br /> � �PLU NG $ ��
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<br /> � ECHANICAL $ �----j�� VALUATtqN OF MECHANICAL INS7ALLATION
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<br /> } QGAS Q ROOFWG Q SPECIALTY [� OTHER �
<br /> � FINISHED FLOOR EI.EVATIONS FLOOD ZONE AREA QYES iV0 ✓�
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<br /> -= BUlLDER ! !� C4MPANY
<br /> SIGNATURE � - —REGISTERED Y�/ N FEE CURRE� Y%N.
<br /> Addre�s �Liaense# �����
<br /> E�ECTl21GIA1�1 GOMPANY'
<br /> SIGNi4TURE REGISTERED Y/ N �FEE CURRE� Y/N
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<br /> Address License# �— �
<br /> 4 Pl:UMB�tt._ GOMPANI!� ,
<br /> } 'SIGNAT.URE ' REGISTERED Y•/,N� FEE CURRE� � Y/N
<br /> � , Address LicenSe#' � �
<br /> � MECMi4NiCAC: . � , . C4MP.ANY _ (�i?n✓� �j{ C� l�l"' /,�r
<br /> j SIGNi�TURE�' �� ,7 REGISTERED ; Y/ N , �E cU�tE� Y/N ' -
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<br /> ; aaa►�ss-= � � �C'�l C7 zP �j f iff � �S�` { . License-# {_,. C IJ �7 /
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<br /> t � , �OfiH��� '`��::> '` CO�AAPAPlY
<br /> � ! ''SIGNAtWRE.:.�: ,� � - " • '`' REGISTERED � Y/.N FEE CURREA' : Y J N
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<br /> Aciaress,�,. _ ` - _ � � - License#
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<br /> ;v.R2ESlDENTIAI.��` '°AttacFt'=2��Plat.P.lans��`2 .se s�o�Buildin �Plans�'1�'set'bf�Enei `Fomis�"R=0-V11 Permit for new.constiuction.
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<br /> " =n:=���:.�,:n�-�•���Minlmum„ten�u(y10)ywo.rking,daySiaffer submittal:date.-:Requi'red�onsite;'�Constructio�'Plans,°Stormwater Plans w/Silt Fsnce instalied,
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<br /> t ��s " �` " Samtary;Faciliti,es<&4,1;.dumpster;:Site=:,.W,ock Reimit.for=subdivisionsJ�arge'pr"�ajeets: . � �
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<br /> /'� �,.GOMMEFtCiAL � A ofi(�j�cofri'piete 5eis vi'B`uilt3ii�g'r^ian�-piu5 a-�_�i-=�a€���r�sge;('t-)��t-�f E.��.�y=f.tse^:s:R-�-1M=P,�rmi?-€eer:eew-sar.s+-uc-�^� _. ._.. -
<br /> / � M1 Minimum ten(10)working days after'submittal date. Required onsi#e,Construction Plans,Stormwater Plans w/Sitt Fence instatled,
<br /> f Sanitary Eacilities�1 dumpster.Site Work Permit"fo��all-new.projects.Atl commerciai requirements must meet compliance
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<br /> i ;:;:StGN:PERM{T .Rttacti(2}sets;afsEngineered:Pians:��{: � -•
<br /> ; �?�,;,. _ ""**PROPERTY StlRVEY requir,ed far..a!l.NEW construction:.
<br /> I '��,�°: -' = - -
<br /> ; ';DI"r`ectiqns: . . x „ .
<br /> '� -'`'�� Fi!l.out application.c�mpletely.
<br /> � °� Owner&Contractorsign back of appiication,nota�ized
<br /> � }; + If over$2500;a Nat�i�e.of Gommenc�ment i�required. (�0.1C uqgrac9ss over$T500j _ ,r
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<br /> ,. .; i4gen#(fpr1fhe�conf�aotor)�or°Power ofAttome}i(for'the oi+vrier}wcruld tie someone wlth notarized letter from owner autho�iz'sng same
<br /> � �=:4VER`;THE�COUNTER�PERMiTTIh1G.,:-,....:.•_(coPY-of cont"ract=[equired}.. , ~ _ _ . _.--
<br /> ` `"`�12eroafs,if stiingies Sev�rers� _ � Service Upgrades A!G :Fences(PlotlSurvey/Footage)
<br /> ' ♦� D�iveways=Not overTCounter if on public�oadways..n"eeds ROW
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