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� ,. _.. �z3-j��,-v�1uua.-,.�:n- �. ..�.«-'.. ." - City af Zephyrhilis Permi#Application Fax-813-780-0021
<br /> -,:�>,i,.4;c��� , �r'r:��r ..
<br /> ���- •• � Building Department
<br /> ,:J'�— -fi e , ir�...ii;;�` i`�:U:iit
<br /> Dafe�.Receiyed;,;�:; - -.I;�,,:.:,,E'�r:;.�� • a. �� � .
<br /> �����'� Phone Contact for Permitting " �
<br /> , .. : . .__ .. . j �, f 3 ._ 7��_ �G3oz.
<br /> � Owner's Name Ll r'c cti,� ,U ' �� ���a n,� y Owner Phone Number
<br /> � Owner's Address . 3 U�� vl U /"t !y-(1�- pwner Phone Number �� � " � ( � ' ���?�¢,fi�.
<br /> Fee Sirnpte Titteitotder Name � � Qwner Phone Number �— �
<br /> Fee Simple Titlehalder Address
<br /> ^ ���JOB ADDRESS � �t-�t�C� [f'� LQT#
<br /> SUBDNlS10N �� – - � PARCEC 1�
<br /> (OB7�11NED FROM PROPERTY TAX NOTICE)
<br /> i WORK PROPOSED e . NEW CONSTR"8 ADDtALT � SIGSV Q � Q DEMOLISH
<br />' 1NSTALL REPAIR
<br />' PRQR.OSED USE Q SFR Q CQMM 0 OTHER
<br />� TYPE':OF C4NSTRUCTION Q BLOCK• • Q FRAME � STEEL Q
<br /> . - � .
<br />' DESCRIPTiON 4F WORK � �'� CG�G2. 1�,��:�'2�- � c.}"E'_�
<br /> BUIGDIFIG SE2E � � SQ FOOTAGE��� NEICoHT •C��
<br /> �Bt1!l.DING $ �'' f L� VALUATtOtV'OF TOTAC GONSTFtOCT1UIV
<br /> . ��, � � � ��
<br /> QEI:ECTRICAL � � AMP SERVICE 0 PROGRESS ENERGY Q W.i2.E.G.
<br /> �PLUM8ING � „ � .� f
<br /> (j 1/
<br /> QMECHANlCAL $ VAl.UATION OF MECNANICAL INSTALLATION ��� J
<br /> Q,GAS Q ROOFING Q � 3PEGfAL3Y � OTHER
<br /> FINISHED FL.00R ELEVATIONS � � FLOOD ZONE A DYES NO
<br /> SIGNATURE ' -������"'��^`'
<br /> BUII.DER `�,r.' Ct? PAPIY �t.J,'�.2/'
<br /> � REGISTERED Y/ N FEE CURRE� Y%N
<br /> Address "License,# �— �
<br /> EZEGTl�iGlAN , COMPANY
<br /> SIGWATURE REGISTERED Y/ N �FEE CURRE� Y/N
<br /> Address - License# �� _ �
<br /> ;,_,
<br /> PI�UIIItBEIt.,, Ct?MPANY
<br /> SIGNATURE REGISTERED Y•/ N ` FEE CURRE� � Y/N
<br /> Address - License# �� �
<br /> . MECMANICAL`. , COMPANY
<br /> SIGNATURE�' ' REGISTERED Y/ N FEE•CURRE� Y/N '
<br /> A8d`r`e`ss' � ' � Licens.e# �� �
<br /> °;;si�,,, . .._.. .
<br /> :...OTHER:: ,:�:. ° CONIPANY
<br /> ' SIGNA'T.URE':'� c� - REGISTERED Y/.IV.. FEE CURREK Y/N
<br /> Address,�=n .E. ,; _ - � ,� - ' License# �— � �
<br /> �"��:ti, �•�••,- � . . . . ...^ •-- •.+ " . F£.r.t�^�' •. - ' ," •
<br /> ��,:,RESIDEN'fiRL•.:�:- ;Aftacti-,{2);;PIot:P.la�'s;`{2}ts'sfs�of`:Bulldl�g�t?larrs;{1)'se#of'Enet9Y:.For`rrts;R`-,O=Vi(Periiilt,for aew.constivgti,on,,
<br /> ,.. ..,.
<br /> :<;*���, ��-.Minimum„tenr.(t1Q)µwor"king;days�.afte��"s"ukimittal�date.�'Required'ansite;'Con§tr`uction Plans,`S`tormvirater Plans w/Silt Fence installed,
<br /> ;:, .. ,.�:::..x�•=.., . . . , :.
<br /> � Sanitary<Facilitie,s:&a1,;dumpster;.Site<W.o,r,k.Betmitfor:subdivisionsflarge:proJecfs -- ' �
<br /> -"�;;�COMMERCli4L Aftach�{2)'coinplete''s'ets�afBuili3ing Plans plus a�ife Safety Page;{1)set of Energy Fotms.ft-O-W F'ermit for new construction.
<br /> - Minimum ten(10)working days after submittal date. Required ansite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> `'�` Sanitary Facilities 8�4 dumpster.Site,Work Permlt"foi a!I new piojects,A11 commercial requ�reme�is must meet campiiance
<br /> ;-�-�,.
<br /> s•�::SIGNrPERM1T -AttacFi`2�'sets�ofiEn ineerecl;Ptans.��= :.t � �
<br /> { ) g
<br /> ����`� - ""**PROPERTY SURVEY re ui.red foc aII.NEW construction.
<br /> �.,+:�- q-
<br /> ��. �
<br /> �*'.Ci[`ectioris: ,��s,�.f:- , _ , • _
<br /> '� Fill.out application completely.
<br /> ��� =0wner&Contractor s(gn.back of appffcatian,naEarized
<br /> `4'
<br /> : 1f over�2508;a Not�ce of'Commencement is requlred. (A/C upgrades over$750Q)
<br /> `'"' Agent(for'ttie`contractor)�or°Power'otAttomey(for ttis owner)would tie someone with notarized_letter from owner authorizing same
<br /> x:�'OVER;THE COUNTERaPERMITTiNG:_ -.(copy-ofi contract required) �""°' -' ,
<br /> ,.��Rero'a'fs ifshingles Sewers Service Upgrades AJC Fences(Plot/Survey/Faotage)
<br /> Diiveways-Not over.Counter if an public�roadways..needs ROW
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