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$��-�saaoza City of Zephyrhi#Is Perrr�it Application Fax 813-780-0021 �
<br /> ' Building Department
<br /> �= ,�
<br /> Date Received . Phone Contact for Permitting • - �Q
<br /> Owner's tdame 2� h Y A�p� Nv�s��s /-�o�l� $a�fi �c�/�; �� �rd
<br /> Owner Phone Number �/3 78� ' .S-SG��
<br /> Owner's Address I 1�� /CJ r�� (9 r�Ar�C t? /� � �i �+� �� �
<br /> Ar F�- Owner Phane Number
<br /> Fee Simple Titlehotder hlame ���3��/ jry I}U�tr� �}����� -� rP h+�c�� Ow'ner Fhane Number � �
<br /> Ree Simple TltteholderAddress �i a'iQ �t�Q.. P �i ta r1s �L ?,�S t� �,
<br /> JOB ADDRESS v��a-�d 1� F#U 2. Z P i!r�rrS �� � S lI Z- LOT# [�
<br /> SUBDIVlSION � � PARCEl.ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE). �
<br /> WflRK PR4PK3SED = e ., NEW CONSTR 8 ADDIALT � SiG(V � Q DEMO�ISH , .. . �n
<br /> INSTALI REPAIR ,F _
<br /> PROP,OSED USE Q SFR Q �COMM 0 OTHER _
<br /> TYPE`OF CONSfiRUCI'ION Q BLOCK • Q FRAME � STEEL Q
<br /> �~ �
<br /> QESCRtPTtON't1F WORK 1`� � �,�� - . r /~' • � ,-�r i • �aLC� Lf 'r� '� � c
<br /> BUtI"DING`StZE �- � SQ FOQTAGE HEiGFlT -�_� �•i A(�/ G 1 a�I�
<br /> QSUILDlNG � ��^ d � VALUJ�TION'ClF TOTA[.GONSTRtlGT[Oi+l
<br /> QELECTRICAL �� AMP S�RVICE Q PRt�GRESS ENEFtGY Q W.R.E.C.
<br /> QPLUMBIfVG �. �
<br /> QMECHANtCAL $ VALUATION qF MECHANICAL.INSTALLATION �t%'✓/
<br /> ��
<br /> QGAS Q Rt30PING Q SPEClA�TY d OTHEFt �.�lv�'�-
<br /> FINISHED FLOOR ELEVATIONS r�� FLOOD ZONE AREA QYES NO
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<br /> BUILDEt2 , y�/ ' . G�'r�v?aR'ANY {�y �
<br /> SIGNATURE .;�� � f � - REGISTERED ! FEE CURRE� Y/N �
<br /> �' ' ��-1.,�'������
<br /> Address �Q5 . � / :t , �� j License# O
<br /> � 'ELEGTRICIAN . COMPANY
<br /> SIGNA'1'URE REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Address - License# � ' �
<br /> ,' x.,_"-.. , _
<br /> F.LUMBER., COMPANY
<br /> SIGNATUR� � REGIS7ERED Yr/ N� � FEE CURRE� Y/N
<br /> Address �. � Licerise#'.� �
<br /> °- .MECH,�IN4CAL � COtVIP.ANY
<br /> " 'SIGNA'I'URE' � REGIS7ERED , Y./ N - FEE CURRE� Y/N
<br /> Add�ess4" ' � License.# �- �' __
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<br /> :: .t}?HE�t::,.:<.". ,; GQlVI,PAEiY
<br /> ,�`.SIGNATUREa, �.� � " REGIS7ERED Y/ N FEE CURREK Y/N
<br /> �,:} �.e':r'e..�., .. . . . . � �
<br /> . -Address�• - - � ' License#
<br /> :`-:REStDENTfAL;;:. A�chw{2);;Ptof:Plan's;`(2}.sefs ofYBui[cltng�Plans;{1)`set'of'Energy;For"tiis;R-O=yY Perm9t.for new.canstiuction,
<br /> 'K, _ -_.:;*;�;�:.�rr,,,--::Minimum;ten;(,10),working`�days-aften;submittal�iiate. Requireii'onsite;Gonstr'iicUon Plans,Stormwater Plans w/Silt Fence instalied,
<br /> kK=. `� � ` y ` Sarntary,Facilities&1ydumpster,,,5,ite:,Wor,k Permit for;subdivisions/Iarge:proJects = ' �
<br /> .q�-r. - _ , �
<br /> ,-=::GOMMERGIAl. At#ach{2)compiete'sets'of'Buitdi»g Plans�plus a l.ife Safety Page;{1}set of Energy Forms.R-Q-W Permi#for new cansfructton.
<br /> - �-- - Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Santtary Facifit�es&�1 dumpster.5lte=Work Permit fo�a!!new pcbjects.Al!commercial requirements must meet complfance
<br /> ;?;'.SIGN>PERMIT -Attacti°(2)sets.qf,Engin�eered'Plans:��- •
<br /> """*PRORERTY SURVEY„required for.aILNEW canstruckian.
<br /> ,.�: , --........, ._., � .. .n - .,. _. <_
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<br /> �::Dt�8C�01'18: ,._: . . , -
<br /> � _� �Eill:out application comple#ely._ ._ .._. __.�..-.-_. _, _
<br /> : t'lwner:�Cor�tractor"slgn tiack af appNcation,nataf�ized;
<br /> �` if over$Z500;a'Notice of Gom�mencementi is required. (A!C upgrades over$750Q}
<br /> " �..� �.n„s_�r;'�^N':,°>y ia„�,^,c.`.���.:14`tC�:J :r�' -�: '�'! t;'1,. ' -
<br /> Agent{for�th'e�cbntractorpo�;Power.of;Attcimey{fc�r;tlie awne�)wauld tie someane with r�otarized letter from owner authorizing.same
<br /> vl: `'Yt:!`:....}i�...� . ..�.,+
<br /> ';'ONER�:THE'COUNTEi2�PEF2Mt�TiNG,r.,..�; (copy,of'cbntraet required) j �"' � �
<br /> ` .. ;�:-:,..,: .
<br /> °;Re�oofs if'shingles• ~Sewers �"� Service Upgrades A/C Fences(PIoUSurvey/Footage) .,..,, ,-r���_.
<br /> t�;,rw:'�:3i,'';:!. ' �
<br /> ° � _,. �„ti.,-�<<<, .,;:�;�` :� -'.
<br /> - Driveways-Not over Counter if an pubtic'r`oadways..n"eeils ROW "�•' '' '�'""""�` � •
<br /> ,r�''' ,i:7�G��1 !;"s;���;:�' .rS,,H"„.
<br /> ,y_:,�:;.i��.v��_;�C�'•t::. ,. '_'r,�_ '
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