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e�$aeaoo2o City of Zephyrhilis Permit Application Fax-813-780-0021
<br /> Building Department .
<br /> Date Recelved •
<br /> -: Phone Conlact�forPermittie
<br /> Owner's Name r Ues�Q,,,.�P � Owner Phone Number
<br /> Owner's Address ��� 1 � Owner Phone Number �
<br /> Fee Slmple Titleholden Name Owner Phone Number '
<br /> t -
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ��J I� � �,.� � LOT# �
<br /> SUBDIVISION PARCEL ID# �3` �.lo' -O�o o -pfl m o � p p m O
<br /> (OBTAINED FROM PROPERTYTAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
<br /> INSTALL B REPi41R -
<br /> PROPOSED;USE Q SFR [� COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK ' Q FRAME Q STEEL Q
<br /> DESCRIPTION OF WORK � S `
<br /> BUILDING SIZE ' � � ` SQ FOOTAGE ,5 �HEIGHT ` �
<br /> QBUILDING $ VALUATION`OF TOTAL CONSTRUCtION '
<br /> QEL•ECTRICAL $ � AMP"SERVICE " Q PROGRESSENERGY Q W.R.E.C.
<br /> _ , , -
<br /> QPLUMBING $ ' � (J6�
<br /> � � ��
<br /> QMECHANICAL $ = � VALUATION OF,MECHANICAL INSTALLATION.
<br /> OGAS �� ROOFING Q SPECIALTY, Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ fV FEE CURRE� ,Y/N
<br /> Addre�s � License#
<br /> ELECTRICIMI , COMPANY � �
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�`' Y/N
<br /> ,, , .
<br /> Address . Lfcense.# � - �
<br /> PLUMBER COMP...ANY � -
<br /> SIGNATURE� `` REGIBTERED Y/-N. . /•,FEE CURRE� Y/N. ° �
<br /> Address License# ,. -
<br /> MECHANICAL' COMPANY, _ '
<br /> SIGNATURE REGISTERED . Y./ N . FEE CURRE�- Y/�N ,
<br /> Address'�� �-.. '-, - � .- -- - ` , - Ucense#
<br /> ,. .. . . : . . - -
<br /> - , ` �,(�. .
<br /> OTHER •` ,: '' � � ';COMPANY ` `. �J I�N�YL (�`�?T(/� .
<br /> SIGNATURE' ":s' _` �`� � ` "�REGISTERED ' Y/ N�.� FEE CURRE� Y/N
<br /> Address. °�„,7: �,: - � ��C . License#� C-CC��'v���f'Z.
<br /> �,-�r -
<br /> RESIDENTIAL, . •AttacFi(2);P-_IotiPlans;:(2)sets:ofBuild'ing�Plans;'(1)set of'Energy4Fortns;�R'-O=W�Perrrilf fo�new construcUon,
<br /> ,s Minimum:ten,(:1A)-wo,riitng;days'„.after,:subiniNafdate:'::Requlred onsite;°Constnicbon-.Plans;StortnwateF`Plans w/Sllt Fence installed,
<br /> ��� Sanitary FacillUes;&�1;dumpste,r,,Site_Wor1c;,Permit,for subdiyislons/large_pr6jects;:_ " ��� � � ��
<br /> COMMERCIAL. Attach(3)�complete sets of Builcling'Plaris plus a Life Safety Pege;'(1)set of Energy Forms.R-O-W Permit for new construction. ______—
<br /> - Minimum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Santtary Facilltles&1 dumpster.Site Work Pertnit for all new;projects:All commercial requlrements.must meet compUance
<br /> SIGN PERMIT Atta6fi"(2jsets of Engineer,ed:Pians.;, ..z� � -• � �
<br /> "'•PROPERTY SURVEY reguired for all NEW.00nstrucUon. _
<br /> Dl�ectlons: - � � '" �
<br /> Fill out eppUcaUon wmpletely.
<br /> Owner&Contractor sign back of applicatlon,notarized
<br /> If over�2500,a Notice of Commencement la requlred. (AIC upgrades over$7500)
<br /> " Agent(for the contraotor)`or'Power of Attoriiey(for�tFie owner)would be someone virlth notarized letter from owner authorizing same
<br /> �VERTHECOUNTER-PERMITTING• •��-`•�Front�of;Applice4ionOnty) s_ f•��• - � �
<br /> Reroofs if shingles Sewers . Service Upgrades A/C �Fences(Plot/Survey/Footage)
<br /> Drivewaya-Not over Counter if on public roadways:.needs ROVtI; �
<br /> ;.,,.. . � :..,.,., „ ...�.. ,. .._ , . ,..�-., �,�,
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