|
813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021 I
<br /> • Building Department
<br />� � i i
<br /> I Date Received o � _ Y�,� I '
<br /> Phone Contact for Permitting '� l
<br /> f / /'/'� �/ , ��
<br /> Owner's tdame �' ,�, �,�, Owner Phone Number �(� V%� 7�� '
<br /> OwnePs Address !� CC � Owner'Phone Number ,
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �� �, P S L LOT# � ,
<br /> suauivisioN L 5 PARCEL ID# I I`o�(Q��I-ODl f?-I �DD-On�D '
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) j
<br /> WORK PROPOSED e . NEW CONSTR B ADD/ALT Q SIGN �. Q DEMOLISH
<br /> INSTALL REPi41R
<br /> PROPOSED USE Q SFR Q COMM Q OTHER .
<br /> TYPE`OF CONSTRUCTION Q BLOCK �• Q FRAME 0 STEEL Q.
<br /> �� - -
<br /> DESCRIPTION"OF WORK �(��� .
<br /> BUIL"DING SIZE SQ FOOTAGE� , HEIGHT • '-Ii'
<br /> QBUILDING $ VALUATION'OF TOTAL CONSTRIJCTION
<br /> QELEC'TRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ �/�5����Ge
<br /> f COl//J/y �//G��
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I
<br /> OGAS Q ROOFING Q SPECIALTY Q OTHER ���`� � �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �
<br /> �
<br /> BUILDER �� � COMPAIdY I�,TT . Y I I I�G
<br /> SIGNATURE REGISTERED Y/ N EE CURRE� Y/ ,
<br />' Address -License# �S DD�I 1�? i
<br /> 'ELEC,TRI,CIAN COM PANY "
<br /> SIGNATURE REGISTERED Y/ N -' ��FEE CURRE� Y/N. �
<br /> - � , i
<br /> .- Address` _ License# � �
<br /> . I
<br /> _ � �. .,� '
<br /> ' PCUMB.ER,. COMPANIf-� '.
<br /> SIGNATURE REGISTERED ; Y-/ N' "', FEE CURRE� Y/N
<br /> I _ = -
<br /> , Address License# :�
<br /> � • �
<br /> ; .MECHANICAI: � � COAAP.ANY
<br /> '" SIGNATURE� ' � REGISTERED Y/-N' FEE CURRE� Y/'N - '
<br /> Add�e'ss � �• � ' License.#
<br /> �'�.fii,;. ..... , , . . I
<br /> .; OTHER=• `'=,_ � COMPANY
<br /> .'°SIGNATURE�; <` -+ - ' - - REGISTERED Y/.N. FEE CURREK Y/N I
<br /> , . , . . - ' j
<br /> � License# �
<br /> Address•., ; _ _ - - �
<br /> ,,;.;�.... . .. -,;: : _; ,- . .
<br /> �
<br /> � .. � ..�. ... . �. �:• � . •.`,,' f`': ,� _
<br /> �':RESID,ENTI'14L:a;��.• Attach;,;(2).PIoE�'P.lans;,�2)�seisof`Building•Plans;(1�)`set'of�EnergyiForms,;R=.O=W,Permiffornew,constiuction;`
<br /> ,4<-
<br /> ���u 3•-;�,-,_�w;Minimum':ten�(1Q),working?clays afte�subinittal:iiate. 'Required'onsite;Gon'stn%ction Plans,`StormGvater Plans w/Silt Fence installed,
<br /> �;`:•> Sanitary,Facitities�,8��1�:dumpste.r•;,Sifer,Wor;ic Permit fo�;subdiVis'ionsflargeiprojects�_ ' ° � '
<br /> -s,,COMMERCIAL Attach'(2)'complefe`'s"ets of"BuilclingPlans plus a�Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> - - Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, �
<br /> Santtary Facilides&1 dumpster.Site Work.Permit fo��all new projects.All commercial requirements must meet compliance '
<br /> �:��SIGN:PERMIT '"Attach(2)�se4s-_o.f;Engineered;Plans.� , ��,
<br /> ,���;: " *"'PROPERTY SURVEY,required for aILNEW construction.. , I
<br /> -- - ,
<br /> ��;
<br /> �;DI�ecHons: �,�:;=.:;.: ; ..
<br /> � �Fill-ouhapplication completely.
<br /> - O.wner:&Contraotor sign.back of application,notarized
<br />;� r If over$2500,a Notice.of Commencement is required. (A/C upgrades over$7500) �
<br /> .��- w�.r..:....�..:;
<br /> _ Agent'(forth'e�cont�actor)�or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> �;;OVER':THECOUNTER�PERMITTING, (copy_of•contrac@required) � I
<br /> :".'Re�oofs if sfiingles Sewers Service Upgrades A/C Fences(PIoUSunrey/Footage) � '
<br /> .IF.x�'r.��� ,- .� .. t. -
<br /> ` Driveways-Not over Counter if on.public=roadwayss:needs ROW'"' ' u.`. ` • • �`�; j
<br /> ' '. ;',. ..ii�:�._. ;Y� ';i' , 'r'y. `. ,�t ^ F '
<br /> �, ',i_'`.` ,' .;��. .���.r` �„t." �� � -' ' .� .� 1
<br /> 4' ' ' �' , 7 '
<br /> .. 1° �iL'`.,. ,. .�,_;.1'� .� , 'S . .. ,. ' .�, . � ... � . . � I
<br /> ., . .ca r . . ._ r<,-.�_ �� as_ :- ..,.-._ :.. ,. .<-.. ..r :. ,. .,. v - • , .. _._a,'
<br />
|