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a��-�so-oo2o City of Zephyrhilis Permit Application Fax 813-780-0021
<br /> Building Department
<br /> Date Received , �1(� 1 phone Contact forParmlttln _ �
<br /> Owner's Name � � L�Gt., Owner Phone Number
<br /> Owner's Address Owner Phbne Number
<br /> Fee Simple Tltleholder Name Owner Phone Number
<br /> ,. � .
<br /> Fee Simple Titleholder Addre�a . .
<br /> JOB ADDRESS LQ, � � LOT# �lp.
<br /> SUBDIVISION PARCEL ID# '� 01.S (� �
<br /> . (OBTAINED F�PROPERTK:T�rcE)DEMOCISH �
<br /> WORK PROPOSEQ ^ NEW CONSTR ADD/ALT Q` SIGN"
<br /> �_ INSTALL 8 REPAIR
<br /> PROPOSED�U$E Q SFR Q COMM � � [_] OTHER
<br /> TYPE OF CONSTRUCTION Q -BLOCK '' Q FRAME Q STEEL Q �
<br /> DESCRIPTION OF WORK' x , I
<br /> � � � �3'C�.�� , .
<br /> BUILDING'SIZE - Y�`L SQ'FOOTAGE,� , HEI,GHT � IO�
<br /> �BUILDING $ VALUATION.�OF'1'OTALCONSTRUCTION �
<br /> � O l��o
<br /> [�ELECTRICAL $ n/-�:��p0 AMP SERVICE Q PROGRESS ENERGY Q W:R.E.C.
<br /> O�w —
<br /> �j]PLUMBING $ �� ,_ -
<br /> [�MECHANICAL $ p(�" VACUATION OF-MECHANICAL INSTALLATION. �"�"
<br /> Ub �
<br />� QGAS Q ROOFING .Q SPECIALTY � , OTHER . �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANIf�� A��Y1 L'�"S
<br /> SIGN/iTURE REGISTERED Y/ iV FEE CURRE� Y/N
<br /> Addres� I�-I � �(/JG'` _ � C�cense# -��4(7��a'�u �
<br /> ELECTRICIAN .-C'OMPANY 1�1� - ��
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� ' �Y/N
<br /> � , - ,� � . —
<br />-- - AdwTas:� ��- • - - - - —-= - — - --- ,-- -�---License:# -- --- - -� --- -
<br /> PLUMBER . C.OMP.ANY , �'�0
<br /> SIGNATURE� ' ' , .REGI&TERED Y/-N FEE CURRE� ` Y/N �
<br /> Address 1 �'l��l,�, �-� License,# � l�. o�� �
<br /> MECHAfVICAL" � . COMPANY � Y'� , �
<br /> SIGNATURE � � ttE��§7Erieo Y.,/ N F E CURRE� Y/�N
<br /> Address' `�� �'��'�Q., '- � License#
<br /> OTHER - : . � _ � ',COMPANY'. ,
<br /> SIGNATURE ��•- ' ' ' � � ' "REGISTERED ` Y/ N_.-. FEE CURREh Y/N
<br /> Address � -� • � �' ' � License#
<br /> ,._.._ ,. .. 4.r-,: - �. 1 ,.., �,. �
<br /> RESIDENTIALN � AttacFi'(2),Plot%Plans;�(2)`sets:of'Building�P.lans;(.1)sef of-Eneigy�Foims;R=0-VU Permlt far new construcUon,
<br /> , ,;..Mlnimum�ten-(1A);working;days after,;submlftal'date.��.Requlred onsite;;ConstrucHon=Plans,Stormwater'Plans w/Sllt Fence installed,
<br /> ��= Sanlfary Fac.Ilide�&.1;dumpster;,�fte Work:_P_ermtt��sut�di�isionsllarga:pco]�cts__�;..____.�_ � _______
<br /> COMMERCIAL Attach(3)complete sets of B'uildirig'r�lans plus a Lffe Safety Page;�(1)set of Energy Forms.R-O-W Permit for new construction..
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConsUuction Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles 81 dumpster.Site Work Permit for all new;proJects:All commercial reyulremen�must meet compliance
<br /> SIGN PERMIT Attacfi"'(2)sets"of Engineer,ed�Flaris..,� �_�- � � ,
<br /> ""PROPERTY SURVEY reguired for all.NEW constructlon.. ; - � ' y � • �i
<br /> ___.v__. ___...__ _ , _, . •
<br /> Directions: .. - ' ' '
<br /> Ffll out applicadon completely.
<br /> Owner 8 Contractor sign back of applfcatlon,notarized � .
<br /> If over�2500,a Notice of Commencement Is requlred: (AIC upgrades over 57500) ' � ,, , �
<br /> .. �-r;,.,,
<br /> . _ , . ,. .
<br /> Agent(for the contracfor)or Powe�of Attomey�(for Uie ovmer)'would_be someone with notarized letter from owner authorizing same .
<br /> DVER THE..COUNTER PERMI7'TING -•-: •(Front-of Application-Only)- �
<br /> Reroofs if shingles.;;�:";Sewers='- -Service�Upgrades A/C Fances(PIoUSurvey/Footage),a _
<br /> . , �• ,� � , . _ -. ----_..:.. -- ._._ :-=- --'-=-.-.- -- ,
<br /> Drivewa -Not.over Counter if on'public roadways..needs ROW � {'"`" �' '' � •
<br /> I►a. . .�; ;r,;.,r., �� ,,�i':V''��±;;�,� �Y'.
<br /> ;t� r�tar,.,- . �- . „ ., "h,— , -•�r �j �'i 'c :.. �:,tc d_; _; r d,� � _ '`
<br /> .. ._......:., .:t..— ..�.>�-..: � - : - . , � '_."�;�'.. ., ., � . .� . i�;
<br /> - i;,'_��;,_.. : -:.._�.:w._ .�.�. _..:_:. —.-.
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