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813-780-4Q20 City of Zephyrhiits Pe�mit Application Fax 813-780-0021
<br /> Building Depaetrn�nt
<br /> Date�tecetved ���"� -° phone•ContaatforrPermtftln� � S"i -
<br /> Owner`s Name �`(' t T - ` � /Own�r Phone Number � , � ,
<br /> Owner's Address "1� � ��"�' '""�'f`ti..`'b � . �Ow�er Phone Nutnber. .+ ��'�
<br /> Fee Sim�9e Tltleholder Alame �— � �� Owmer Phone Number -"�_����
<br /> - 3� - � . -
<br /> Fee 3fmpls Titlehalder�ddress �
<br /> JOB�DDFYESS � 1 � � y,\ �V�-Q_ Z �'lr \L S Lf3T# �_1��
<br /> $UBBiVIS10W ,�[ "��� ��1'L�� PARCE4ID# ' � 0�5~ �� "���� a��� � ,, �
<br /> ., , -(QBTAlNEDFRQAl:PRQPERTY.TNCNOTSCE) -
<br /> �� WORKPROPOSED �=.;NEWCONSTR, ADDlAtT `�` S1GN`�" 'Q• �' 'Q` DEMOL`ISH
<br /> � e.� .liVSTAi.L � : ,, F2EPAIR �� -
<br /> PRBPOSEDEUSE � C] SFR. C] ''COMM " � �]' OTHER " " � - ' '
<br /> 7YPE QF CONlSTFtUGi'!ON [�� . .BLOCiC •• 'Q. � FRAME �� STEEC �Q �
<br /> . • � -
<br /> DESCRII'7'IOPI OF WORa' ' Y1 C(�1� (F�'i' (��'1
<br /> BUILQlNGSfZE �� V� ��SQ FOOTAGE"('�� � HEIGHT!�r 1 � �
<br /> ,��,J:
<br /> �BUILDING � ����y�, VALUATION'OF�tOTALCONSTRUCTION , -
<br /> �ELECTRICAL. • r$'���'O�� AMP SEFtVIGE 'Q :PRt}Gf2ESS�M1IERGY Q " W:R:E.C.
<br /> �._.._ U d -.�
<br /> QPLUMSihiG ��= ����i 5'� ' Y
<br /> ���V
<br /> QMECHANtCAL $ ' ° ' VACUATION pF`MECHANICAL INSTALLATlON. � �
<br /> OCuq5 [� ROC?FiNG .Q SPECI�4LTY [�_ _ OTHER� , _
<br /> FINISHED FLOOR ELEVATIONS � � FLOOD Zt�NE AREA QYES _NO
<br /> BUILD�R COMP�fY^ -� �'C" -
<br /> SIGNATURE REGISTEREQ Y! N ��cuRt�n - ' Y/N'
<br /> Addre�s � �^-� ��Q.. - - : - �License#:! �G-L..�,��5,�.,��
<br /> ELECTRICIAAi�l: � .. . ; :,�COiWPANY�' . t � - ' - .
<br /> SIGNATURE '�' REGISTEREd Y! N PEE:CURREA'." Y/N' '
<br /> --- -�tic�P�ss —-- �Rr- � -..- -- - .... -- _�,.�...-'�__----.,-----,-- -_ - - - -- -- �i p-. - - --
<br /> . _ , _.Ucense#��� r�� �a�'b��
<br /> PLUifA�ER" _ , . ... � '. C.OA�F�P�VY _ .�_ - . .. . _ . . - �
<br /> SIGRIATURE � �-.. - . . ; �REGl3TEREQ Y(-N.> . rFEE�CtJRREt� � �." Y I N `-
<br /> Address , � � - . „Liaense,# C �
<br /> WiECHAAtiCAL' � ` � . COPAPfaWY . ,
<br /> �IGNR'fURE � .. � � . . ��c�sz� Y,! N ;. �CUR�n. Y i�iV� , � ,
<br /> Addre�§ � � ' - � , ' � . , ,` _ � . . ` License# r " � ,
<br /> OTHEF2 _� . . � . . .. , ,''tCONiPAfVX .,, , .
<br /> SIGNATUi3E' `:: -' .. �- ` _� .. . ' „ . :' �REGlSTBRED'' ` " Y!`N, ��E CtiR�Eh Y i N . � .
<br /> �ddre$s ,: , .. . � , _ _ .. � -. Ucense#�1"` - . . �- . .
<br /> }.. . .. .i. .. , .�y..,�`��.: _• ;} , . �. .. -:»., . .<F� " " .
<br /> ESIDEPtT(1,4i;..,;�.,�Attach'(2};PiofPians;;(2)`sefs:.of$Bullding,Pians,�(1)�'sefof�EnergyfFomts;�R-O-1NPermitforaew.construction, � `
<br /> 5 ;�. Minimum�ten�(1.0),worlcing;"day,s;.after,�sutiiiinittal'date`+Requtreil onsife;:Constiitck(on�Plans,$tormwater'Pians w!Slkt Fence instaited,
<br /> "' Sanitary F�c(lities&z1:;dumpster;;Site Work�Permit,for subdiyislonsllarge pmje,cts.:..;�?,;; -� ° '� - � " ' "� - �
<br /> OMMERCtAL Attach(3)•comptete sets�of Buildirig Plans plus a�Ctfe Safety Page;�(1)set of Energy Foims.R O-W Permit for new:constnactiorr.= ' ` `
<br /> Minimum ten(10)working days'after submltkal date. Required onsite,Constructlon Plans,Stormwa2er Plans wl Silt Fence tnstalted,
<br /> Sanitary Faciflt(es&1 dumpster.-Site Work Pertnit_far all pewtproJects.All cammercla!requlrements must meet campi}ance-'
<br /> otGW-P1ER�II6'� Attactt={2}sets-of-Engineer.ed�Flans:._:,�°,:=��„,- .. � : � -- - = ' _ _ .
<br /> «•••PROPERTY SURVEY reguired for all NEW constructian:., ���` ----_- -- ---- -, _-. _ �-
<br /> ireations: � .-, . - � _ ,
<br /> FIII out applica8on completely.
<br /> Owner&Contractor sign back of app!(cation,notarized
<br /> !f over;62500,a Notic�of Commeraaerreen#fs requlred. (AfC opgrade�ov�r$7500) -
<br /> .�. - • _
<br /> Agent(foc the contraotor)or Pbwer of Attam`ey`(for ttie�owne�}woutd be someane�vith notarized letter from owner authorizing same
<br /> r .
<br /> VER THE COUPITER�PEttMIT114YG- •••--�(Front of-AppllcaUan-Onlyj;, � ' .
<br /> eroafs if shingles Sewers Service Upgrades A!C Fences(PlotlSurveyJFootage)
<br /> DNvewa Not oyer Co .. � � -,, --- .� �, .
<br /> ys- __unter if on,publfo roadways.:needs ROW" � . . . , j+. '_ . ,.
<br /> � ,.. ,`..,, Y '.. ._ , . ; , � �- r.x� ..,= .r r. .,._ w. , .. - . ... �. _
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