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s�3=iso-oozo� City of Zephy�hfll5 Perinit Appiication Fax-813-780-0021
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<br /> Bullding Deperimenl �
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<br /> Oal`a pecelJed _.„ _; phorie Corilact tdr PermiHln'
<br /> Ownar's Name. . ,... • ...: . _. .._..• Oivrier Phbue Ndmd'er .. .
<br /> OWn�i'9 Ad'dra'sa'!..._. ._. . ..._.. .'--•-.... .... ......... ._ _. . ... O�tinei Phohe Nurri6er _. . . ._..�,.... ._
<br /> Fae 9lmple'fitleholtler Name .'..........: . ......_ .__,........ ., .. . ... 6wnNr hliohe Numlfmr ._.. . .__.._.._..._.... -
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<br /> Fea9lmpleTllleholderAddrese . .... .. ......... . .... .........._.. ... .........__.. _..__........ _.---..._--.-.
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<br /> JOB ADISRESS ... � W�.1K. . �.. _ . . .. _.,a�i..... LOT fl ��
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<br /> .SUBUIVISION . . . ... . ,. . .... . . . . PARCEL IDp . .. .... .... ........_..<_ ... .. . , ... ..._... .. _ .
<br /> � (OBTAINED FROM PROdERTY TAII NOTICE)
<br /> WORK PROPOSED e NEW CONSTR B ADDIALT .�.�', SIGN Q Q DEMOLISN
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<br /> INBTALL REF�AIR
<br /> PROPOSED U6E Q SFR. Q • COMM Q OTHER " '
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<br /> 'fYPE OF.CONBTRUCTION' Q BLOCK Q FRAM� ' •
<br /> CJ STEEL Q _
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<br /> : DESCRIPTION OF WORK YlIL. . . ��._.... . .. c.. . ... . .... . __ .... . .. .... .....- :--.... .
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<br /> 9UILOINO SIZE ..... .... ....... .. SQ FOOTA(3E ,�.�. _,, HEIOH? C�
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<br /> QBUILDINa $ � VALUATION OF TOTAL CONSTRUGTION
<br /> QELECTRICAL $ ' ' ' AMP SERVICE � PROGRE§S ENERGY r�. W.ii.E.C.
<br /> QPLUMBING. $"' :''' �'' r_
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<br /> �MECHANICAL $,' - V '" VALUATION OF MEbHANICAL INSTALLATION c /� �
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<br /> QOA3 Q RbOFIN� Q SPECIALTI'.� OTHER
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<br /> FINISHED FLOORELEVATIONS FLOOD ZO,NE AFtEA �1'ES NO
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<br /> BUILDER COMPANY .. . . . ... ..:_.__.._._.._... _. . .... . ... ....._,.. .
<br /> SI�NATURE ... . „_ , „ ,. ,.,, ,'.... ....... . ... REGIBTEREO _Y.I.N.- �FEE CIIRRE� � �_Y.L N_.
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<br /> Addre�e �;, . ".'-.` - . . -- , -
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<br /> < �. .... ._ ..... . .. ......__...,..... . Llaense#� ...... ....
<br /> EIECTRICIAN • �COMPANV _-. . ..._. . . . . �
<br /> 916NATUHE RE(31STER�D Y/ N � FEE CUiiREA' Y I N -
<br /> Addresa . . . Llbense fF
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<br /> pLUMBER � COMPANY .. .. . - ---...... ._ ....
<br /> SIONATURE .RE618TERED .Y I N..� ` FEE CURREA ��Y I N_. � '
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<br /> Address - . .... .. ... .. .. . .. ........ .... Lice�se# ,..._...... .. . ...,.
<br /> MEGHANIGAL GUMP.ANY � ' p�__ H�S�D��.
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<br /> SIONATURE _.. ....' ... ,. ... ..�.,. .. . . . .,,.. REGISTERED � .Y.LN,_ � FE�CURRE� � _Y./N.. � �
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<br /> i.. �. Lioense# �rlC�l4.ls _. . �.
<br /> Addrese /r�...� . `l$.., � ,�39. , �
<br /> OTHER, COMPANY ..... ...... .._... ..__. .,_ . __ .._. ._ _. . ,
<br /> SIGNATUR� REOISTERED Y/ N'.- kEE bUahen ' Y/N
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<br /> Addieas .. .. . . License# .. .. _ ... . . .
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<br /> RESIDENTIAL Allech(2)Plol Plana;(2)sels bt Buildirig Pleh§t(1)9et of Energy Forms;R•b=W Permlllar neW conslrucllon,
<br /> Minlinum len(10)workiny deys eTler'su6millal iiele. Recjul�ed onsile,Conslruclibn Plans;'Stormwaler Plans�.v/.Slll Fence installed,
<br /> Senite'ry Facilllles&1 durrijister;Slle.Woili F'eririll for subdlvl'slonsllerge PioJedis -
<br /> COMMERCIAL Allech(2}coriiPlele sels o(Bullding Plans plus a Life Safely Page;(1)se�of Eneigy Forrtis.R-O-W Permlt(o�new cohstrucllon.
<br /> Mfnimum len(70)workin'g days efler submltt9l dale. Requlred on"slt0,Conslrucllon Flaris,StortilWeler Plens w/SII(Fence In'slelled,
<br /> Sen�lary.Facilill.es 8 1 d'umps(er.Sil'e Wtirk Permll forell nevi proJecls.All Comrrlerclel requlreinenls rtiu'sl rimeel eomplience
<br /> 91GN PERMIT Altech(2)aels o(Enylneered PIAns: _
<br /> ""F'ROPERTY 3UftVEY requlred for ell NEW dansliuctlon: -
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<br /> -'r.:�=i-"�'-H-1�.+i�'. '�' :�3�.-r:-':�y'-.-�:+:::-1.:I.:i-I�i�i� {=4c.F-1:.1- .
<br /> • Dlrectlone:
<br /> FIII oul eppllcalion completely
<br /> Owner 8 Conlreclor slgn tieck d1 eppllcelton,nolarlied
<br /> II over;2BOD;e Nolloa o/.Commencement le raqulred: (AIO upgradas over 57600)
<br /> " Agenl(lar Ihe conlreclor)ot Power ol Atlorney(for lhe owner)wouid be someone wflh noledied leller Irom owner eulhodzing seme �
<br /> OVER THE COUNTER P�RMITfIN6 ,(copy ot Conl�acl required)
<br /> Reraofa If shingies Sewers Service Upgredes AIC Fences(PIoVSwvey/Foolege) • I
<br /> , Driveways-Nol over'Counler if on public roadweys..needs ROW '
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