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813-780-0020 City of Zephyrhilis Permit Application Fax 813-780-0021
<br /> � ;;.-�� V Building Departrnent
<br /> Date Recelved � Phone�Contact for�Permittln � �J �O z — ��l
<br /> Owner's Name / . S LT� �`T/�[ !�/'D P�.77P� pNrner Phone Number 13— T�/ '"��0�
<br /> Owner's Address � ��/�- � o� [.�f{��Q i rL- Owner Phone'Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Addresa
<br /> JOB ADDRESS �U ��Y � /�f�r' �L�e i�/f'������ LOT# �
<br /> SUBDIVISION �L��' /'BE/� �'LS. , PARCEL.ID# �� `^� a� ���� �S�Ov �Do�D
<br /> . (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED ;. NEW CONSTR ADD/AW' Q SIGN �Q Q DEMOLISH
<br /> _ � B. INSTALL +REPi41R
<br /> PROPOSED;�U$E - Q SFR [� COMM Q OTHER �
<br /> TYPE OF CONSTRUCTION Q BLOCK ' Q FRAME � STEEL Q
<br /> DESCRIPTION OF WORK• �i �L� � I�/�I �"B LB � �Q� �� �' o� TD/�
<br /> BUILDING SIZE - ` SQ�FOOTAGE� HEIGHT � .
<br /> QBUILDING $ VALUATION'OF TOl'AL CONSTRUCTION
<br /> QEL'ECTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ , "
<br /> Q MECHANICAL $ ����, � VALUATIOIV OF;MECHANICAL INSTALLATION.
<br /> QGAS Q ROOFING :Q SPECIALTY, Q OTHER� -
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES ,NO
<br /> BUILDER COMPi4NY � ` '
<br /> SIGN�►TURH REGISTERED Y/ N FEE CURRE� Y/N .
<br /> Address Llcense#' •
<br /> ELECTRICIAN �COMPANY � � ' � �
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE��' '='Y/N '
<br /> Address � � ',. .. Ucense#_ • '
<br /> PLUfVIBER , . COMPANY ,s.
<br /> SIGNATURE" r�' . _REGISTERED Y.I.N� '�;FEECURRE� Y-/N -
<br /> Address �.Ltcense# � -
<br /> MECHANICAL .,-�,�, ���J COMPI4N1f,. !�'�!�/��S /' ����L' r��
<br /> SIGNA7URE REGISTERED., Y,/ N , FEe cuw2E� Y/•N
<br /> Address�'°'..-.��I�I ��� Z' i��5' �i�. � License# ����3� � .
<br /> OTHER - • � � ` ,COMPANY � , ., �
<br /> SIGNATURE�.-� `:. ,- � - ��,
<br /> � � ' REGISTERED` • Y/ N.., FEE CUR�� Y/N _
<br /> Address � ' � �License#' ' � ' �
<br /> ,_.,.:. ,_ �
<br /> RESIDENTIAL'�; � ,Attacfi`(2),:PIot�Plans;.;(2)sets.of�Bullding;Plans;(1)set'"of-'Energy�Foiins;R=O=W�Permlf far new construction, � , `
<br /> ��_Minimum�,ten_(:1,0)�working;d"ays.after�submiftal°date::<Requlred onsife;=Constiucd`on-Plans;Stonnwater'Plans w/SOCFence installed,
<br /> � '�����3anitary Facilitles:&;1,,•,dumpste,r,.Site Wor1c`Pennit for subdiyisionsAarge-proJects'.`,:�;,��•• ' ' - ' '
<br /> COMMERCIAL Attach(3)complete sets'�of�Bullding Plans�plus a Ufe�Safety Page;O set of Energy Forms.R-O-W Permit for new construcUon. _
<br /> Minimum ten(10)working days after submlttal date. Requlred onsite,ConsUucBon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliBes 8 1 dumpster.Site Work Permit for all new�projects..All commercial requirements must meet compliance '
<br /> SIGN PERNEIT Attacti(2)�s`ets ofEngineer,edrPlans.:, ..�:::��;._ ,, �. �'. , ,
<br /> ""PROPERTY SURVEY required for.ali NEW construcUon.
<br /> Directions: - �- --•� '
<br /> Ftll out applicaHon completely.
<br /> Owner 8 Contractor slgn back of applfcaUon,notarized
<br /> If over 52500,a Notice of Commencement 1�requlred. (A!C upgrades over 57500) ,
<br /> �� "-:'.+C....��; . _
<br /> Agent(for the�contraotor)or'Powe�of Atfomey�(for tFie owner)would be someone with notarized letter from:owner.authorizing;,same,�;,L,,�,�,_�;���,� ,."_.. :_, ,
<br /> - �a� �r. :>_�i r�., , - �.7 . , .�,.r . , ., �.
<br /> OVER THE COUNTER.P_ERMIT:TING �.;;,1�(Front of i4pplicatiomOnly)°;';`�"'"���, ` ` ' � "". ' .' .'' , -�;;"_
<br /> Reroofs lf shingles Sewers�s ,;�„ ,.Se,ryicefUpgrades,NC Fences(PIoUSurvey/Footage) "` ' '' � s".?�' �'�''�'` ,, '='::' �''''`- " ;
<br /> ` �� : „ �!,"j `;� �•,
<br /> _ ._...... `tr... ;,• ..., ',' ".: ' ' -� '�•1�'-'1. ; I". , •i.. ,���;��\� ::..;o�:1'i; . �c _ ' - _ '
<br /> �i �� '�" `' ' " = ` :'i) ,' ui:` � a i q. ,,ir3;;����:�i.;r ';�; -
<br /> Drivewaya-Not over Counter if o�i.public.r4,adways,.need's ROW�`�„�;', � i - ;I.s:,`;`,• ;%`• '
<br /> `� ...`� ,.. .,� ...'i�4';�tl;�JCJl� ,: , . .��c �'} . :;u`.a'ks."�,r:,.��-.,..�.�.;o�Y.�.;:lr„'+�.-.;�, .' �
<br /> ',I:� -.
<br /> :.—.y��a°-*"�n�).�^'�iti�'':`:�•_vy-5...::yyy+-,nja
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