|
813-780-0020 City af Zephyrhilis Permit Application Fa�c-813-780-0421
<br /> ' Building Department
<br /> Date Received .. Phone Contact for Permitting � -
<br /> •-�1--
<br /> Owner's Name 'J 4� °t.� U�'��/�`� Owner Phone Number O��J "- � .S-" .S`�,5
<br /> Owner's Address ��� �1���K (r '�l�J� �' /,(f/� Owner Phone Mumber �� �
<br /> Fee Simple TiElshotdar Name �- �� Owner Phane Number � �
<br /> Fee Simpie Tttieholder Address
<br /> �oa�a�ess 5 f� 2 q �'Mt3t�' �1� �t� � �l f�L �or# L�.._J
<br /> Su�D�v�s�oN SUM,�d�t4 /,�'l�t �� Pa�xcE�.lo# �'�'33 j f'��,� 3 8-�3�j
<br /> ( BTAINED FRdPA PROPERTY TAX NOTICE) �
<br /> WORK PR4POSED � e . NEW CONSTR� ADDlALT � SIGPi Q � Q DEMOLtSH
<br /> INSTALL REPAIR
<br /> PROP..OSED USE SFR Q COMM �� OTHER
<br /> TYPE'.OF CONSTRUGTION BLOCK • Q 'FRAME �. STEEI. Q
<br /> DESCf21PTiON OF WQRK � I t d(�� �I� L r� �{�. �'/�'�" �?U�} _
<br /> BtttLA1NG SIZE �.�r d11 �G�i I��I�..� SQ FOOTAGE -I Y' �� NEtGHT -.�� �
<br /> _„
<br /> „ ,,.... � 1
<br /> �8���'���G ��' ��C� � ��, VALUATtON'OF TOTA�CQNSTRt1CT10N
<br /> �=
<br /> QELECTRtGAL $-------�~�"Y AMP SERVlCE Q PROGRESS ENEFtGY Q W.R.E.C.
<br /> QPLUMBING $ ' �C�Y(��Q.'" �
<br /> ��
<br /> QMECHANtCAL $ VALUATtON t?F MECHANICAL INS7ALLATIOIV �i(� �-
<br /> � \�
<br /> �,GAS � R40FING [� SPECIRl.TY � OTHER `�
<br /> FINISHED FLOOR ELEVATIONS r�� FLOOD ZONE AREA QYES NO
<br /> �_
<br /> sui�a�r� ���, , cor���r ��'3���A./�
<br /> SIGNATURE ��� REGISTEREp Y�/ N FEE CURRE� Y%N
<br /> Address "License# � �
<br /> ELE•G,TE2i,G1AN : GOMPANY `
<br /> SIGNATURE REGISTERED Y/ N FEE'CURRE� Y/N
<br /> ` Ai#clress Licettse# �- � �
<br /> PCUNIBER: ., CQMPANY-
<br /> SIGNATURE , REGISTERED Y•/ N FEE CURREf� Y/N
<br /> Address License# � �
<br /> MECHANICAt * COMPANY �
<br /> SIGNATURE�'" ' REGISTERED , Y/ N EEE CURRen : Y/N : .
<br /> Adil�e"ss�= � � ' Licens.e# � �
<br /> , OTHER'� ` , � . , ' GOMFANY
<br /> :'SIGNATURErI; � � ' REGIS7ERED .,Y/ N. FEE CURREK Y/N
<br /> �iidres5. ' - - - - _-_- Licans�#�-�- �
<br /> �r;t.:` ;::;,. .: .. ; �., ;. ,,. . .. .
<br /> �'RESlDENTIAI.`: Attach?{2);P1ot�Plans;�'{�)asetsdf•Building�Plans;(1}�set of�EnergY,Fottn,s;F3=0:VY Fe�tt.far n.ew.const�uction,.
<br /> ;�.-:.��;�--.Minimum„tern.(:10),working;daqs=afte�su6mittal�daCe: Requ'ired'onsite;Constr'uction`Plans;StormVuater'Plans w/Siit Fence instalied,
<br /> � n`''` �� �Sanitary�FaciUtiesr8��.1>.dumpster;Sife;Wpck:Fermltfor..ysubdivisionsAarge'.projects� ' " '>' - � -
<br /> �:.;COMMERCtAL At#acti(2}�compteCe'se#s"of'Build3rig�P'lans plus a l.ife$afety Page;(1}set of Energy Fotms.R-O-W PermEt for new canstrucEion.
<br /> •• � - Minimum ten(10)working days after submittal date. Required ansite,Gonstruction Plans,Stormwater Pians w/Silt Fence installed,
<br /> � SanEtary 1=aciliUes&9 dumpster,.Site,Wotk Permit foi�aA•new proJects.AU commercial requirements must meet compliance
<br /> �:�•:StGN�PERMIT `Attacti(2)se'#s.of`Engirieerecf Plans: � � •
<br /> � � '""*PROPERTY SURVEY required for.aILNEW.cpnstructlon.... � ,
<br /> ::� _ - - - - -
<br /> ��Directions: , - a • . ,
<br /> '�Fill�out applicatlan completely.
<br /> � 'Ovuner.8 Contractar sign back of apptication,natarized
<br /> . 1f aver$2500;a Notice ofCommencement is required. (A!C upgrades over$750d) _
<br /> .�...'M' P.:i i-t.�r.:�:�
<br /> ..Agent(for the•contractor)°or Power-of`Attomey.(for ttie owner)wauld tie someane with notarized letter.from owner authorizing same
<br /> '��OVER:THE�COUNTER:PERMITTING,�'...; ;;,(copyofconfract�reqyired) ' � ' _ Y�� ' � �
<br /> ;?�Re�oofsif shingles Sewers Service,Upgrades AlC ' Fences(Plot/Survey/Footage) , � ' � .
<br /> � _ ,. , _ _;.., �. ,_. F,1„ i. ._. , ' � ' ,.
<br /> Diriveways-Not over Counter if on,pubiic°roadways..needs ROW, - _`
<br />
|