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<br /> $��-7so-aa2a City of ZephyrhiHs Permit Applicatian Fax-813-78Q-0021
<br /> - Bu�lding Depat#ment
<br /> V^ �� 4,w J
<br /> Date Reasived ' Phone Cantactfor Permitting �• � r�± cS � _ ,.��,�
<br /> Owner's Name ������--,,} 1 �-1V�C��'!G�l� Owner Phane Numbec
<br /> Owner's Address Y� . �6/ , �� ��.SJ�� Owner Phone Number � �
<br /> Fee Simple Titleholder Name, ���� ! � Owner Phone Number �! �
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS t� �j % �1 d�-�6'"lC- � �.S Q/�,. LOT# ��
<br /> su�o�v�sia� �"��1/�/�... �.�-f�'� �,a�cce�.i�# �3:��-�- -���1'�—�2���I"U —111?�
<br /> (OBTAINED FROM PROPERTYTAX NOTICB) �
<br /> WaRK PROPOSED .. NEW CONSTR ADD%AL7 [� SIGN C] [� DEMOLISH
<br /> e INSTALL REPAIR
<br /> ' PROP,,OSED USE. Q $FR Q COMM � OTHER ,
<br /> TYPE`OF CONSTRUCTION �~–'BLOCK ~ a FRAME �� ST.EEL Q
<br /> .� .
<br /> . DESGRtP7iON OF WORK. � ��8� D(�� LLp 6� 3f) ,,�- �tZ,l��'�E".:S
<br /> BUi�D1NG SIZE ��i� SQ FS�i4TAGE C� NEIGHT •�i—�
<br /> :< �;i_.,
<br /> ��BUlLDING � b�� 'v" VA�UATItaN`OF`COTAL CONSTRUCTlG}N
<br /> �
<br /> QELEC7RlCAL � � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. •
<br /> OPLUMBING $ � �
<br /> � � ' \ �
<br /> 4
<br /> QMECHANICAL �$ ���— � VALUATION OF MECHANICAL INSTALLATION ���
<br /> �
<br /> QGAS �ROQFING Q SPECIALTY � 07HER
<br /> FlNISFiED FLOOR E�EVATIQNS (��� FLOOD ZONE AREA QYES NO
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<br /> �BiJtLDER � C0l9fIP,4(dY
<br /> SlGNATURE REGISTERED Y�/�N FEE CURREn Y/N. . ._
<br /> Address � � -License#`� �
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<br /> ����cz�ici�w � - cotw�pr�irry , . . � �- .. . � _
<br /> ..SlGNATURE REGISTERED Y/ N-�x�`' ''F�e°cuRREn " . Y/N: '
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<br /> Address' • ,< „ .,.License`#` t•k= ;'r ���
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<br /> P@UMBER.,. • , 601VtPANY�`;- ' � , , , � ,_ - . .
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<br /> SIGNATURE REGISTERED•_ , .��; {Y,/�:N�-' : :• Y:FEE CURRE� Y�/N`
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<br /> Address � License# ���
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<br /> MEGtiAF11GAt;., � , - COMF.ANY-, ..
<br /> SIGNATURE`' - � � � :,Re�isrE�o. =Y/:N.. F�E,cURrz�n, Y-/N . � �
<br /> aaarass�::.�, � - : � � L�c��s.e.# � �
<br /> _07HERy�_ - - .. . �.:= � ��GOMPANY Ul� ��s'�lL��'
<br /> "`�=SIGNATtJRE;#..==.5 .-� � � � � REGIS7ERED Y/.N- FEE CURREK Y J N
<br /> _ lAddress=:s , `Q°.��• 'sc�'�.�:: �- �1`7 License# ���7"��.-`t I �
<br /> , �-----
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<br /> %,'�#2E$IDENTi,at.-:�=' <Attache 2'PIot=Plans}'�2 sefs�of}Buildln 'Plans;'1� set ofEner ��Forms;R=04,W,Peiriiit for new.const'rucdan, � . ,
<br /> , ,.,. ..�M_ . -.:, �,} .t }'� 9' C}` 9Y,'.., .-
<br /> ;R};�,;."�t,;;:«t?�>;Minimum:tenh,(;10.�'�working;days:;afte��subriiik'tal�date.;Required�orisite;��Con"striiction�Plans,�Storinwater�Plans w/Slit Fence installed,
<br /> �-s �� San'itary%,Facilities,;&�fi�dumpste.r-;:.SiCe,;,,,W.,or,k Permit:#ar;sabdivisians/large'projects'.. " � " -
<br /> �,;,f ., _ .
<br /> r;:;•.GONIMERGIAL Attach`�{2)�complete sefs`of'Builtiliig P1ans plus a L'ife Safetyr Page;(1)set af Energy Forms.R-Q-W PerrnPt for new canstructian.
<br /> " Minimum ten(1p)working days after submitta!date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed,.
<br /> ;�;�;-:,' Sanitary Eacilities 8�1 dumpster.Site,Work Permit"fo��alt-new projeots.All commerciai requirements must meet campliance
<br /> S.°'�SIGN�PERMIT "�ttacti(2j-sets:_of;Erigineereci;Plans::r= , . - .
<br /> - � "***PROf?ERTY StJF2VEY rerquired fo�all;NEW.construction.- _ _ ,, , .. �
<br /> ���Diiections: ,��c�,;t����;`. .. ,
<br /> - � Flti�.aut apptication compietefy.
<br /> ; C1+Amer'8�ContraGtor sign.back of�application,natarized
<br /> `If ove�.$2500,.a Noticerof�Commencement is required. (A!C upgrades.over$T504) _ , -
<br /> "�'.""''' .Agent°(ftir�th`e�conf�actor)�or�.P.ower•�ofAttomey'(for'flie ownerj would tie someone with notarized ietter#rom owner authorizing same _
<br /> ; �
<br /> -, PY.of�.contract-.re ui�ed '`,`�, ,', __ _. � .
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<br /> �:;.0._'V.ER,THE�COUNTER;:PERAAI'RINCa.�.._ (co q ' )
<br /> �=*Reroofs.ifshingies Sewers Service lJpgrades AiG Fences(PlatiSurveylFoatage}
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<br /> Driveways-Not over Counter if on public roadways::nA�'ds°Ra�lVt �"�"` .� " .' "-'--"'.` `.�
<br /> " •?:F':.4{ViE4��iFo:t!<�ii ::?Mb:': �, " .1.i:3.��;1i,��'r'i��`t.!:).�•.%f[:�ir' .
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