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7 813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021
<br /> -- Building Department
<br /> Da'te Recelved , .phone Contact for Permitting -� —
<br /> Owner's Name / i � Owner Phone Number J�� �
<br /> Owrner's Address v d 75 ° Owner Phone Number � � 3 �
<br />� Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOBADDRESS ���" 2� �3'' LOT# �
<br /> SUBDIVISIOPI PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED � .. NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH
<br /> INSTALL REPi41R
<br /> - PROP.,OSED USE Q , SFR Q COMM � OTHER ,
<br /> TYPE"OF CONSTRUCTIOId Q BLOCK •• Q FRAME 0 STEEL Q
<br /> . � , .
<br /> DESCRIPTION OF WORK � aU �OU � �a O ��
<br /> BUIL"DING SIZE SQ FOOTAGE HEIGHT •
<br /> QBUILDING $ Q(J � VALUAl'ION`OF TOTAL CONSTRIJCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ � i ��
<br /> � '� I
<br /> QMECHANICAC $ VALUATIOfU OF MECHANICAL INSTALLATION
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> -BUILDER �, COMPANY O�,✓l/'P�,
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �
<br /> .,:,.�:. �
<br /> ELECTRI,CI.AN ;. �COMPANY _
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> �aa�ess � License#. °y
<br /> P.LUMBER.,._, � , . , :COMPANY'-,� : ,• � '
<br /> SIGNATURE � ;REG�STERED ;' Y-/�N ` _`. FEE CORRE� � Y/N
<br /> Ad'dress � License#• �
<br /> ' �;";. �
<br /> ;',.MECHANICAL.�- �: ,, COMPANY .
<br /> '�SIGNATURE` ' ' ' " ` ' REGISTERED , 'Y/ N , FEE CURRE� , . Y/N '= � - � •
<br /> ;
<br /> Ad"dress'-�' ' ' � '� ' License.# � -
<br /> '�'�:i':, , _. - . . - ,
<br /> '::�OTHER�� ;�':�., -`� _ ' � ,� COMPANY - �� • - ,
<br /> ,�;�`=SIGNATURE�;'��" *� • - • � � REGI$TERED Y/. N. FEE CURREK Y/N .
<br /> • ., F" :5 , ,.. , :.. - - . � , , . _ . , , . .<-. ,
<br /> � �,Ad�dress:=<<`. "� _ �;;;;: .:�.-:`• � -. � License.# : , , ,
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<br /> '�'°RESIDENTIAL:,�`._.AttacFif.(2j��FlofPtans;;'(2)�sefs�ofBuilding;Plans;µ(�1�)`set'ofEnergy;Forms;R=0=V11•;Perrriit;,for new.construction; :.;�, . , �
<br /> � . ;.���,F;..;�.;;,,jMinfmum;ten°(;1Q);working?daysafter�submittal.`dafe:�Required`onsiterConstniction:Flans;Stormwater'Plans uv/Silt Fence installed,_,
<br /> =� -� "- ' Sanitary Facilities 81 dumpste�;.Site;Wo[k•Perrriit:for:,§utidivlsions/large"projects '�'�` ����`•� � � � • -� '�`- • - � `-} � -
<br /> '�COMMERCIAL •Attach;(2)complete sets of;BuilBing.Flaris plus�a�Life`Safety.Page;,(1)set of Energy Forms.R-0-W Permitfo�new construction.
<br /> , , "; ` � - • Miriimum;ten'(10)';inro�king;days after;submittal�date: Required onsite,.Constri�ction Plans;Stormwater Pla�ns;w/Silt Fence installed,. _
<br /> -�°=' � � ' Sanitary-EaciliUes'&;.1,°dumpster,;Site!.W,ork P.err►iit'fo�%all-new,projects.AII�.commerciaLreq'uirements.must meefcompliance. '
<br /> :.�SIGN:PERMIT, ' 'Attaoh�-(2j:setsof,EngineeretlPlans:��.'::.���, � ��;,° :. , � - , ` � " ` � � -
<br /> ;.,. . .
<br /> `-���` �� """"PROPERTX SURVEY�equired for aII.NE .W.-constiuction:= � �
<br /> :Directions: ' � � _ .. _ _ .. . , • ' . - ' - ' " -
<br /> � '; Fill-out application.compl,efely:- =_ '
<br /> - _ ; ,OvimeY.&Contra�tor sign.tiaok of aPplication;�notarized "_ ' - ,
<br /> , If ovec$250Q a Notice"of�Commencement is�[equired.: (AIC.upg�ades over$7500)�'' ':. , _
<br /> „ s,a?,,:`,- .,-.
<br /> .��"` Agent(fo��th'e;cont�actor)'or Power'of:Attomey-(for-;tFie�owmer)would tie someone witfi.`notarized�letter from owner authorizing:same
<br /> ��.:OVER.THE'COUNTER;PERMITTING � � ��(copy.,of-contract-.required)=,-`,��� ``" - � �
<br /> ���Reraofs�.if shingles. Sewers , _ Seivioe,Upgrades�.A/C' Fences(Plot/Survey/Footage)
<br /> ,. • ,� ,..'._, • • , , _ . -
<br /> _ Drtveways-Nofov,e�,Counter•if.on:.putilic`roadways.:needs'ROW�:• . ���"��"-`� � �
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