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<br /> J�'sasaoazo City of Zephyrhiiis Permit Application Fax 813-78p-0021
<br /> . Bullding Depa►tment
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<br /> Da@e Recelyed " ���.Phone�Goot�ct':for,+Psrmittin '- ��1�3 �i o�— ��y+�
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<br /> Owner's Name �✓�J� � � P"bwni�P ane um�er �� �'" �O��.��►j� '
<br /> Owner's Address �O . � ��f�� Owner Phone.Number� �� �
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<br /> Fee 8ttnpts'[itletiotderName - � Owner Phane Numb�r
<br /> Fee Simple 1'itishotder Addr�aa
<br /> JOB ADBRESS `t�� � �', � ITL L L� LOT# ��
<br /> suBo�vrsio� , �.� ' ___� � ��c��..�c� �11 � f� � �l,�l�
<br /> • ,. . . (OBTAINEDF.RpM.PROPERTY,TAX'NOTICE)
<br /> WORK PROPQSED •_�NEW CONSTR , ADDlAI:T C�� SIGN` '[� [� DEM4�ISH
<br /> ,, e: iNSTALL. REPAIR .
<br /> PROPOSED.USE [�� SFR [� COMM . E� OTHER '
<br /> TYPE OF GONSTRUCTiON.� :�" `r�'BI.00K r � FRAME ° '.[�' "S'TEEL 'O
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<br /> DESCRIPTiON OF WO�iC` �� �'!"'C - �a (� 1 v�" f�L� OC �f}7'7) O�li�
<br /> BRliL1�lNG'°StZE=' ��' �'SQ_FOOTAG�,��: ..HEIGHT"':�
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<br /> QBUlLQING �� V��AT10N�tOF'7'O'1'Al GONSii`#2F1G'1'ION ' �
<br /> QEl.ECTRlC�1l. $ AtUIP 5ERitlCE. . :;Q '�PRC?GRESS ENERGY Q W.R.�:C.
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<br /> [�,]RLUMBING $ � ' , : , '
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<br /> QMECHANICAL' < $ w� +��� �� Vi4LUA1'IONQF�,IUIECHANICALlIVSTALI:F►TIOIV.
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<br /> QGAS [� ROOFING .,[�; ;� S.P.,ECIALI'�Y,:�_];�,..;OTJiER�, ..
<br /> FtiViSHED FI.00R Et�EVAT101VS (�—� ��OOD ZONE AREA ,QYES. .NO ,
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<br /> BUILDER COMPANY". _.... .,�:1;. ` . �-�. . _ � -
<br /> SIGNATURE REGI$TEREO Y/ N �"`°'FEE CURRE�.� 'Y'/'N'
<br /> Address ,.:. 5; #N.:r . ,�#: ,4 r��L'iceinse;#!'� t��=y, �,,, . _ � , . �
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<br /> El.ECTFttClAt+t: _ . , ,,. - ��GOMPANY�: ;,_�:. ;;,:fi�� .-,.;y:, ,_;� :.; = � .. ; . , ,
<br /> SiGNATURE� � ��ts7�En Y/ N �eu��y{ ==Y!�N '
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<br /> PLUN}BER�` ' , -, � ,, GOlM1PAfNY, r �,.F.,.,,;�,. T: ..7 ,. :< :�� :.� ,. _._.,
<br /> SIGNATUiZE`' '`' " - � . . '�REOiST,ERED .Y,/a IV,; �,FEE;CURREP.�� ^Y.�I.N ,. `
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<br /> MECHANIGAL` �� - ;������� �. GQM�ANII. � .�G. . L� �G
<br /> StGNA1'URE� �..�� ' IZEGISTETtED . Y/ iV � ,FEE CURREt�:,. �Y I<�N:.. ,
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<br /> S1GNA'fURE�, .:- - en r�:- .'.-�. ;- ,.•, - •, , _ :Q ,p"=' . , , - .
<br /> 'REGISfERED Y/`N:..� ;FEE'CURRER�• Y'/N
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<br /> 'RESIDEN°fllAl:�;,,..,;Attacti,:(2),�?(ot.Plalris;:(2)sefs_of'BuiltlErig�Plari's;'('1�}sef'of<Eneigq�Fo`rii�`s;xR=0=V1f�Pensilt#ornewrccin'stntatiori,
<br /> r� b;e,;E�Minimum,.ten,(10}�wori�ing�deyys:after�svbmiFtal:datel::Requlred arisite;:GiSnstiuctlon`Pians,�8totrriwater�Plan's w%�Silt Fence installed,--' -
<br /> "' � �Sanitary FacillUes 4&;,1:,dumpster•�Site°.W,orkyPermitr#oe:suti�ivislons/larg"e,�proJects�`�' ;�;��,: = `�'a'' _ .. - • "�' ,
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<br /> CQMMERCtAl. Attach{3)'coiiijiletia'sets'of'Biiitding Plaiis pius a Ufe Sat'ety'Pagie;{'i)set of�Enetgy Fomis.R C?-1tV Petmlttor neuV construetton.-'�_ '
<br /> Minimum#en(10)working days after submittal da#e. Required onsite,Construction Plane,&tormwater Plans w/Silt Fence Instalted,
<br /> Sanitary Fecilt�es 1i 1 dumpster.Slte Wark Pormit for all new�praj�iofs:.:All commercial.t'e!quir.ements,must meet compliance "} �
<br /> .SlGN PERMlT AttaeFi{2j sats of`Eing[neer"�d;Pta�is:�,�:�v^�.,, .. �.3: t�,. .. • . . , ° ' r
<br /> NNPROPER'fY SUR1/EY required for eil NEW,aanstructl'on.. ,. _ � ,e�:�. •
<br /> Dlrectians: .•��:;fk+:.x:u .- -- ,_ - ,. _
<br /> Fili out appllcadon compieteiy.
<br /> Owner&Contractar sign back.of applfcaGon,nat�dzed
<br /> If aver�tS00,,.a,Nottcs;of�ommencemen#Is reqalrsd, {AtC npgrade�over 3T�00) , ..
<br /> �R •''`.Yy��P`tti J'�,;�j�r ' ..
<br /> Agent(far the`contractor)or'Power of Atkortiey(fair the owner)would be�someone with notarized lette��u±m�u a' n �sa��� �' ,. .. .
<br /> OVERTFtE.CGIiNTEE��ERN11T:�fNt�SbS3�{��5�(j(�pT'���OF1�} ""-' " •� 3 i�itf ji1']HJ 47��4i.�T� :�4r.'+�ti��t�
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<br /> Reroofs if shingles Sewers�"`�j•''�O�Serii��o�'�pgrade���A'/,'G�^<,�. �nces(PIoUSurvey/Footage) r,±�;�.��?rn:s1�:9�:• ;°���^�:'+;:+�%uv� `''�
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