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' " aia-rao-0oza Gity of Zephyrhiis Perrttit App}ication Fax-813-784-0021 <br /> BuikYi�g Department <br /> DatTR�ceiv_T e�� Phony C_ omnlaT t�ar FetmlttEng 1�' 7SQ _ 122 3 <br /> 4wner's Name ! ,r� /�/` L G Owner Phana Numbor ��03�.'"�i')2 ' �' <br /> Own�+tsAddress j���`'f �'?tfi� ,}��y_�,� {.}�.y.-1yrq,n, OwnerPhaneNumber � � <br /> �^+ .1..,�.,1�;��,G <br /> Fee Silnplc Tlticholder Name G�'�'V e�+�rJ' Zt rr�s�""j1'� Ownor Phone Humber <br /> '� <br /> Fec Slmpl¢Titlehalder Address �'335 � �'ttC�aL �'K r i �1C �� �3�ii y 2- <br /> J4B ADOR£SS t�...+^F' *y1t' Z t Il 't ��#"" L8T# �� <br /> SUBDIVI510N �^—� PARCEL IOH !3-�'�"ti'np0�"-od+�a-bt515 <br /> �___/,r'' (flS;A�tifO FROM PROPERIY 7AX N�7tCE� <br /> WORKPROPOSEp e NEIYCONSfN�;,� .ADDlAL7 C] SIGN �] Q DEMOIISH <br /> INSTALL Q REPAIR <br /> ! <br /> PROP4SSp USE � SFR COMM � 4TFtER [—f! ��—� <br /> TYPE OFCONSTRUCTION Q BLOCK Q FRAME � STEEI � <br /> 6E3CRiPTl4ti OF WORN �y t"n��Z�t.�i�tSi. L�}�d��c'Y:+5;- �t.►4t�t�' {tis�s .cTtv•.� i�t�c.t�i <br /> BUILDING S¢E I00�"l9fls(2.Q�g Sq FOOTAG� �Q��'� HEIGIiT Z��S�� +�+� �� <br /> ��UtLOtN�+ r1S VALUATION OF TOTAI.CONSTRUCTION <br /> L�.�.�o�Q . <br /> dIECTRtCAL S ��t���� AMP SERVICE �t� Q PROCaRESS ENERGY Q W.R.EC. <br /> ...... <br /> �PLUMBING $ � �,��� <br /> �AIECHANtCAt S �.�} VAGUATtON OF MECHANICAI.INSTALtAT�QN <br /> 7/�.�`�✓� <br /> [�GAS Q ROOFiNG [� SPECtAl.N � 6THER <br /> FINtSHEO FLOOR ELEVATIONS r� FLOOD.ZONE AREA QYES NO <br /> � <br /> BUILDER � � C4MPANY �•��"'�' �.,'�"'A''�"�"-�/� ���+l�y"'1(4'�''�"�'���';((//4a,.• <br /> �� - <br /> SIGN/l7URE l aEG�easo Y f N c6E cuarep. Y/N <br /> aaare$S 2�t�3�. ��ux�z �� at�Q�r,c,t��kn�'_G`T�L 33SG 3 �,�8�58� e�.�::�s�2 sy L^I <br /> ELEC7RtCUW � � CCIMFANY G3"��'cf( � C 5! <br /> StGFtATURE REGiSTeaEo Y t N FEE cuaREa Y 1 N <br /> Addrass Licansau �� <br /> PLUMBER �jti � � COMPAtiY —� <br /> SIGNATURE � J [��,�J REGISTERED Y�/N FeEcuapEt. Y!N � <br /> Fddress �icense#�� � <br /> MECHANICAI � �� COMPANY iL-k�,�t�� �'�� �V~I��.�� <br /> SlGNA7URE REGI9TERED Y(N �E cuunEn Y!N <br /> Address _� License N� <br /> 07ttER �, ._ COMPANY EY !{i�tT C �1rT{�:�t ./1JC`( <br /> SiGNA7tlRE �`� GISTEfiED ��Y,!N FEE CURREA Y/N <br /> Address �"��� ��1Cty�is Ln �![��t{"�It ��L 3�'`J��S �icensex Cp�e 12���a �� <br /> I � � i'Ilzltt � tilll ! { ii [ liitititttlllittiltltlltlltlSlll ! ltttit � iltttl <br /> RESIDBNTWL Attach(2)Pfot Piens;12)sets of BuiMing Plens;(1)sel of Energy For.ns;R-4•W Pertnil(or new cnnstrucGan, <br /> Minimum len(10�workirg days 8ryer submiltal dale. Required onsi(e,ConslrucGon Plan5,Starmwaler PWns w!Sill Fence unslalled, <br /> Sanrtary Eacilities 8 1 dumpster,Siie VYork Permit toc sOtrd'tyis{pnsl3acge projeets <br /> coMMERCtat Attach(2�comgietc sats a!Buitden9 Ptans ptus a Life Satety Page;(t)sst at Enerqy Farms,R-6-�N Permit ier new mnstructie�. <br /> Minimum ten(10)working days 2fl6�suhmitlal dale. Reqmred onsile.Const�uc�on Plans,Smrmvral�r Plans wt SiI!Fenca mstalled, <br /> Sanitary Facdrties d 1 dumpstec S�te Work Permit(or all new pro�nWs.All commercial ruqu+remen(s must meel comp6ance <br /> 51GN PERMlf Altach{2)sets ot Engmeered P{aas. <br /> ""'PftOPEftTY SURVEY require4 for ari NEW cansWctian. <br /> Directions: <br /> Fi1!ottt appUwlian wmplatety. <br /> Owner�Goniracior sagn back at apppcaUan,nakeraed <br /> If aver 52500,�NoUce of Commenaement fs roqulred, (A!C opgrados over 575D0) <br /> " Agenl(for Ihe trontractor)or Pcwer a1 Attomey(for�he ow�erJ wou�d 6e someone vnln notarized letler from vwner aulhorizmg same <br /> OVER 7HE GOUHTER PERMIT7ING (capy ot wntraW required} <br /> Reraots�f shingles Sewers Service Upgrades AIC Fences(PIoUSurvayfFaalage) <br /> DrivQways-Not aver Countes�i an putai�c road4vays.needs ROW <br />