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" 813-780-0020 City of Zephyrhilis Permit Application Fax 813-780-0021
<br /> Building bepartment
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<br /> Date Recelyed ' . ;: p�Qne�Cont�ct far.Parmit#in". �
<br /> Q+rrner's Name ��"�✓�^ . Ow�sr Phone Numb�er ���—7 b��i�-�
<br /> Owner"s Address � ��� � U� Owner Phone'Number � �
<br /> Fee Simple Tltleholder Wame �� � " Oarn�r Phone Number � " , �
<br /> Fee SimpOe Titleholder Addresa
<br /> JOB ADDRESS � ( ��� S O�n l� �"� LOT## �_�
<br /> SUBDIViS10N �� � PARCEL ID� `
<br /> - (OBTAINED F.RORA.PROPERTYTAX NOTICE) .
<br /> WORK PROFOSED, � NEW CONSTR ADDIALT � S1GN� [� C] DEMOl,tSH
<br /> �_ INBTALL 8 REPAIR �
<br /> PROPt�SED�tJSE . Q SFR � GOMM � UTHER
<br /> 7YPE OF CON$TRUC'f10N � ��' ' BLOCK ' 'Q FRAME �� �STEEC �Q
<br /> DESCRIPTiON OF WpRK' n}, K7 u� �(�� '�AG'Q - �
<br /> BUilDING SlZE � ��S$FOOTAGE ��� . HEtGtiT�.0 C'?�
<br /> QBUItJ?ING � VALUATION+"G1F T01'AL CONSfiRt)CTtON ''
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<br /> QEI.ECTRIGAL � � � AMP SERVICE Q PROGRESS ENEl2GY Q W.R.E.C.
<br /> QPLUMBING $ - �
<br /> ��_� ' � '� .��
<br /> �MECF{ANICAI $ " VA�UATlON OF;MECliANIGAI INSTAILA'flOit! "� ��
<br /> [�GAS Q ROOFIf�1G :Q SPECtAi.TY [�] OTt1ER
<br /> FINISHED FLO�R EI.EVATIONS ��� FLOOD ZONE AREA C]YES y NO
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<br /> au«�r� ' caMp;aEnr.� _ C�v2/t� �'1��
<br /> SIGNP►TURE REGISTERED Y/ N FEE CURREP ' Y/N
<br /> Address ��� � �� L� ° Ctcense# � {
<br /> ELECTRICIAI�1: , : ��GOMPANY - '
<br /> SIGNATURE � REGISTERED Y! N FEE CURRE�'�' '-�Y/N
<br /> Addre�s ` ,� - License# �� �
<br /> PLUMBER � CQtf�P,AHY = �. `
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<br /> SIGNATURB"� �" � , _REGISTERED Y_/ N - �
<br /> ,, ,,, , , ,,FEE CURRE� Y-/N,
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<br /> Addres� Lictjnse# �.. . u�
<br /> MECHANtGA1: '- ' ` � CCiMPANY '
<br /> SIGNATURE = � � �� ` � ' REGISTERED : Y�/ N . ; ,FEE CURREn Y/=N -
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<br /> Address°�°�:_:.�• - . � , " .� � < ` . License#'
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<br /> OTHER � � " ., � � �'� ';GOMPANx." . � , '
<br /> SIGNATURE ._ ' r - � #� ' t " a • �' " REGIS7EREDz Y/ N , �FEE CURRE� , Y/N
<br /> Addrsas . - ,- , � � ' � �License#`�� � Y
<br /> � . � :: ,;,r-:,.�,:.. . .. . , . .
<br /> RESIDEN'tiA1:•` � :Attactr`{2}�Rlo#�Plaes;:.(2}se#s�;of:Bull�ing�Plaiss;`(1}set of�Energy�Fann�;_R�W Perinik f6t new consbuc�on,
<br /> , f,Minimum;,ten.(1.q)�,worliing;days�after,,;submittal�ilate.�:Requtied onstte,:Construc8on`Plans,�Stormwater`Pians w1 SOYFence instaifed,
<br /> �t "���'Sanitery�Facilttles�&;,1�,dumpste„r.�Site_,,W.ork�Permit�fqr;"subiiivisloinsllarge';proJeg#s;._y�_,;;. '
<br /> COIHMERCiAL Attach{3)'complete'sefs'of Sultatng Plai►s plas a C1fe S�af�ify Page;(1}set of Enetgy Forms.R-Q-W Permit far new constructlon.
<br /> Minimum ten(10)working days aRer submittal date. Required onsite,CanstrucUon Plans,Stortnwater Plans w/Silt Fence Instatied,
<br /> Sanitary Factpd�s&1 dumpster.Site Wark Permit'for all nevrprojects.All cominercial requlrements.must meet compllence� - � '
<br /> SfGN PERMlT Attactiy(2)sets of`Engiiieier,ei3�Plans.,.� -.� � . -
<br /> •`•'PROPERTY SURVEY'r uired,for all.NEW,.construcUon. .
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<br /> Dlreations: . .. � .
<br /> FIII out applicatlon completely.
<br /> t3wner&Cantractar stgn back of appitcation,notarized
<br /> tf over�Z500,a Plottce of Commencernent is required. {A/C upgracies aver 57500)
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<br /> .t.., .y�* t _ .. : ....
<br /> '• AgenC(far the crontractor)or'Powe�of Akforrmey jfor`tFie ouvner)would ba someone with notarized letter trom owner authorizing same
<br /> OVEFt THE COUNTER PERMITLiNG�r�.-�-:•:(Front of-ApplicationyOntY),'���- s�? -
<br /> Reraofs if shingles Sewers � Service�Upgrades t�7C�� Fences,(Plot/Survey/Foatage) -
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<br /> Drivewaya-Not aver Counter if on pubitc roadways..needs RC1VN''+ � ; :'
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