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D � ei3asaoaza City of Zephyrhi(Is i'ecmit Application Fax�813 760-0021 <br /> Buflding Department <br /> Data Racetvsd I <br /> PhoneContaetforPormitting� - <br /> f !Y't'TT"7-�7� <br /> Dwr�e�'s t3ame ��o" �� QwnatPhono Numher <br /> Owner's Address �� 3 �OwnecPhono Numbor � � <br /> FooSfmpto7itieholdor.Namo � � 4wnerPhang'Number �� <br /> fan Simpia Titlahoider'Addruss <br /> � L�JOB ADpRESS �� �"' I �I V; LOT# <br /> SUBDlVISIOH �� � PARC$l.ID# � ����1 `J��'-'C,1 a�2L3 <br /> (OBTA�NEO FRQM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW tON5TA AD�lRL.T �..� S(GN Q Q OEM4�ISH <br /> e JNSTALl. 8 REPAfR <br /> pROPOSED USE Q SFR Q COMM � OTMER <br /> TYPE OF CONSTRUCSlOH Q 8lQCK Q FRAM@ �] STEEL Q <br /> DESCRIPTIONOFWORK �-[�� �Pi�k'.� `� 1 �2•�j fi�ri. t�aC_ K--( �i'�� ` <br /> SU1IAfNG SIiE � � SQ FOOTAtiE[� NEtGHT;� <br /> -r�-r`�-r-e-�-t- <br /> QBUILDIN4' ��"� VALUATiONr.OFTOTACGONSTRUGTtON <br /> �__ <br /> QELEbTRICAL �� AMP SERVICE Q PROGRES$'ENERGY Q W,R.E.G. � <br /> QPLUM8fNG S �t/1 <br /> /"�,�J <br /> r r� <br /> '�{JIECHANlCAL 8•t-L�-��� VALUATION,OF MEGHANICAI iNSTALLA710tJ � <br /> QGAS Q ROOFING Q SPECIALTY,0 OTMER � <br /> FINlSHEp FLOOR ELEVATI{tNS r-� FLQOD ZONE AREA QYES NO <br /> � <br /> • �„�-R,D,i-b,i-by-i- 6,�1„L,rf;,i-,. . :. . . . ... . . . . . . . . ._. <br /> BUILDER � GOi41PANY � <br /> SIGNATURE REoisietteD, Y/N FEE CURREA Y I'N <br /> Address Ltcense#( � <br /> ECECTRICIAN COMPANY � � <br /> SIGNASURE � � REGISTERED Y/N' fE£CURREA Y/N <br /> (�'� i <br /> Address License# I � <br /> PLUMSEI2 � � COPiiPANY � <br /> 5tGNATURE REGISTERED Y/N. FeecuRaEn Y.IN <br /> Addtoss Ucense#_��, <br /> �..... . <br /> MECHANICAL �'"""� CQMPANY •�Yl � �G <br /> SIGNATURE � '""� ae�lsrEaeo Y/ N FEECURREA, Y! <br /> �t�ti ���^ (n/ <br /> Address 'Licen=e#'���� <br /> 07HER COMPANX <br /> S]GPIATIIftE �' � REGISTERED Y�I N FEE'CtlRREh Y 1 N <br /> A"ddress LicenseiF� I <br /> IItl.t>tllSII � I.IILItt1I [ !:{ 212III'�I ! lIIItTItiltitIlittl2lilt:ittll / i-I1 ! [ <br /> RESIOEN77AL Aktacfi(2)Piot Piens;.(2)sets of 8uiiding Plens;(1}set of'Energy Forms;R-0•W Permlt for new construction, <br /> Mlolmum ten(10)wnrking days after.submittal dete,,Requf�ed onsite,ConsWctlon Plans.,Stortnwater Plans w!Sflt Fence installed, ' <br /> Sanftary FacillUes&1 ducripster,SIte.Wock Pertnitfor.su6dlvisionsllerge ptqJects <br /> COMMSRCIAL Attach'{2}compleSe sets.af 8uildtr�g Plans plus a'Life Safery Page;'{i}set af.Etiergy Forms:R-O-W Pertnit for new wnstivctton. <br /> Mlnimum'te'n'(10)avarking days after submittei date.'R'equired onsita,Constructfon Plans,Srortnwater Plens w1 Sllt Fence installed, <br /> Sanitary Faellilles&:1 dumpster.Slte Work PeRnit forail naw pro}ects:All commerclal requireme"nts must meet compliance <br /> SIGN PERMlT Atta6h(2)sets of Eng(neered Plans. <br /> ""PROPERTY SURVEY requlced far alI'NEW con"stnictfon. <br /> • 4-I-1.-t-i-ta-l-i�f��-t-t-t-i-t�-1-s�.H-L-+--h1-�-t--4i-f-a-�--�-i-f-a- <br /> plreeQotts;• <br /> FIII auGapplicaUon completely. <br /> Owner&'ConVactar slga back of applicatifln,notarizad <br /> 7i ovor$2600,a Nadeo of Commencomont(s required: �AlC.upgrados ovor 57600), <br /> " Agent(far the contrector}.or Power of Attomey(tor.the owner)viould tre so'meone wilh notarized lettertrom ovmar authorizfng sarne <br /> dVERTFlE'C4UNTER PERNtiTTTN� {cagy of cantract reqpired} <br /> Reroofsitshing�es Sewers ServiceUpgrades NC Fences.(PtoVSurveylFootage), <br /> Ddvsways-Nat over Countar if on public raadways..needs ROW <br />