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s�saso-oozo City of Zephyrhilis Permit,4pplication Fax-813-780-0021
<br /> , �• Building Department
<br /> Da4e Received . a _ �?J � ' Phone Contact for Permitting , D � � � — �
<br /> '�` � `�`�° ��z ya�
<br /> Owner's Name , (Z� ��11�'� 2f Owner Phone Number
<br /> Owner's Address r �, �y �r�r� �N���SS
<br /> 'Zio d� Owner Phone Number
<br /> �
<br /> Fee Simple Titleholder Name � �JJ 'ZS Owiner Phone Number
<br /> Fee Simple Titleholder Address . (�. Isa 7i SS• �`i
<br /> JO�ADDRESS O�P S( � ��,.�- i2rn, J LOT# �
<br /> SUBDIVISIOPI LcJt/ � PARCEL ID# 3�= �5"p� '00�� r' ��(� ��Q�Q
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e ,. NEW CONSTR e ADD/ALT � SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROP,OSED USE Q SFR Q COMM 0 OTHER ,
<br /> TYPE'OF CONSTRUCTION Q BLOCK •• Q FRAME 0 STEEL Q -
<br /> • �
<br /> DESCRIPTION OF WORK V A8'l2-'l� P V�LI D!0 �NS � t5 C �j1L�3
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> OBUILDING $ • VALUATION`OF TOTAL CONSTRUCTION
<br /> �
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION -� `� , ���
<br /> �' I
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO
<br /> BUILDER �/ � O PAIdY O�N���'
<br /> SIGNATURE " o REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAN . COiNPANY
<br /> SI('sNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> Addr�ss _ License# � ,
<br /> . . . �
<br /> PLUMBER.,., , , COIIflPANY
<br /> SIGNATURE REGISTERED Y•/ N. FEE CURRE� Y/N
<br /> Address License# �
<br /> - .MECHi4NICAL COMPANY
<br /> `SIGNATURE'' REGISTERED Y/ N FEE CURRE� Y/N � . -
<br /> Add�e'ss�' ' ' L:icense#
<br /> >',i:_. � .,, , _ . .
<br /> .'�OTHER� "°E' ' ' COMPANY
<br /> `SIGNA7'URE�� :- - � ' REGISTERED Y/ N. FEE CURREK Y/N
<br /> � r ... , . , . .
<br /> �Address- - � ^ ' License# � � �
<br /> ��:� . . , - -
<br /> �.:RESIDENTIAL^' Attaph;;(2p:RIot�Plans;f(2):`sefs�of Buildi,ng,�Plan's;(1�);set of�Energy'Forrris;;R;O=VV;Permit=for.new.construction, • -
<br /> � �_ - ,�-:Minimum:tem(�10}working:days'after submittal�date. ;Requirecl�onsite;Con`sUiiction Plans;'Stormvirafer'Plans w/Silt Fence installed,
<br /> � �f�Y �� Sanitary Facilities;8�;,1;,dumpster;SiteiWork.Permit.for:sutid'ivis'ions/large;p�ojects` _ - ' � "
<br /> �`��COMMERCIAL. Attach_{2):coinplete.sets of:Building.Plans plus a L-ife Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.-
<br /> � - , „ Minimum:fen,(10)wo�king days after.submittal date. Required onsite,.Construction Plans,,:Stormwater Plans wl Silt Fence installed, ,
<br /> . - _ - Sanitary Eacilities 8 1 dumpste�:_Site Wo�k Permit fo��-all new projects.All commercial requirements.must meet compliance
<br /> %SIGN.PERMIY Attach(2)sets of:;Engineered Plans:'.= ` . `
<br /> ,� - . , ,�' "•*PROPERTY,'SURUEY,required for a11;,NEW construction: ' - , .
<br /> `Di�ections: " . , , , _ �_ .. - - ,
<br /> �Fill'out application.completely,_ � .
<br /> " •.Oumer&Contraetor�sign back of,aPplication;:nota�ized, .
<br /> Ifover$2500,a Notice.of.Commencement is required. (AIG upgrades,over$7500)
<br /> . - Agent(forth'e cont�actor)or�Power`of'Attomey.(for'tFie owner),would tie someone with-notarized letter from owner authorizing_same �
<br /> �`OVER`.THE�COUNTER:P„EREIAITTING. . ' (copyof'contracf-required)' ' " � '
<br /> _�Reroofs if.shingles Sewers _Seivice.Upgrades A/C Fences(PIoUSurvey/Footage) -
<br /> Drtvevuays-Not over Counter if:on.public roadways..needs ROW_ ' - ; ^1. •^-�.�'^�'•�""'-'`•-"`""'•':` . ""
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<br /> � ' �, ��:''�•.'is�. .i. •ri.:. ']: �.`, . -� ' ' ;:-" ; �.�.�:1
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