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_ _ __ _ _ _ -� <br /> a�:i-rso-o�zt� City of Zephyrhlls Permit Applic�tion Fax 813-7$0-0421 i <br /> = . Bu�lding Department . � <br /> � <br /> Date Recalved ,. ,, phone=Conta�ct'forPermittin ; <br /> � <br /> Owner's Name � f C�� Clwner Phone Number �� ' �S C� ��,i��b` � <br /> � �VP . ; <br /> Owner's Address �J � Owner Phone Number � � � <br /> , ;. <br /> [� (� <br /> Fee Simpl�Titleho(der Name � , �� Owrier-Phone Number ` �` <br /> i: <br /> Fae Stmple TitEehotder Addr�ss j <br /> d08 ADDRESS �{37'# �_____� � <br /> . �. <br /> SUBDIVISlQN . � . � PARCEL,ID# <br /> � , (OBTAINED'FRON(PROPERTY;TAX NOTICEj � <br /> WORK PROPOSER :NEW CONSTR' ADD/ACT Q' SIGtJ' Q Q QEMOUSH '-` <br /> � ���: �INSTALL_ �� ��REPAIR ; . { <br /> � <br /> PROPOSED��USE . Q SFR, [� COMM • � OTHER f <br /> TYPE OF C�NS7RtlCTION �[� � BIOC '.Q FR/1ME . [� 8'i'EEL Q � <br /> DESCRtPT10N OF WORK �. �����.�1 `� C�-��� ^� �— �C�l�`v� <br /> i <br /> � <br /> BUILDlNl3"SIZE`'. . SQ FQOTAGE�i - ,,HElGHT� . �Y 7C �" ! � <br /> f <br /> �. . .. . ' �� .'a. � � g <br /> �BUILDING $ ���� " <br /> , `�-�... VALUATION`OF't'OTAL"GfaNS�'RIJGTION" t <br /> t <br />, QELECTRICAL �� AMP SERVICE Q PROGRESS ENERGY [� W.R.E.G. � <br /> QPLUMBING ���� � � <br /> II _ <br /> i <br /> C]MECHANICAL $ VALUATION OF.MECHl11JICAL INSTALI:ATION s <br /> . � <br /> QGAS [� ROQFING :Q SPECIALTY Q 07MER ; <br /> FINISNED F�OOR EI.EVATIONS � � F�OOD ZOEtE AREA QYES. f�t0 i <br /> I <br /> - i <br /> ' � <br /> E <br /> 9UILDER '���^*�� C�MPANY'' � C�1..+-�`r'�"e- 'C� i <br /> StGNATU#tE ��� �V { REGIsi'EREo Y t C+! . " "F�E CURREh Y!N ! <br /> ,,, i <br /> Address , � - � + <br /> k.icense#'�� j <br /> ELECTRICIAN; „,. � `-COMPANY ' " _� I <br /> SIGtdAT11RE � �E��s't��t�o Y 1 N t��cti��n�t ' �fY!ht ; <br /> ; <br /> Addre�s ' , - � . - - License:# � � � ' <br /> _ ; <br /> PLUMBER ` � COM.P.,ANY � � <br /> SIGNATUI2E` ` ' � FtEGlS7£RED' Y.l:N.. FEE CURRET Y-!N <br /> Address Uc�reSe# �l : _�-�� <br /> MECFIANICAI: ` � ` ' � COMPANY, ' <br /> SlGNATURE ` ` . , t��ts�i� } : Y.i N .. ,:..� ��cu�� . Y.l:-1� <br /> - {: . - <br /> Addresa° . � � : , A . , - , � � L[cenSe# �� � <br /> OTHER � . . . . '' ;CORA.PANY � • ` ' ' , <br /> SK#l�IAT�i#ZE .".� ; :, 'F,. ".�=,+ :` - . - . . " REG1STEitED'` '- Y I N:.; FEE CtlRREh � - Y I H) <br /> Address , st� - _ , , Ucense#`� �- <br /> '' � c w=r r,,,,,,�—.. _:• 3 ._.,�,0�;�,:_..�a., �; p:�..�;..�.:,.:;.�� t<,. ;; . .. ., .- �� , <br /> RESIDEN71At;;;: ,Attacli'(2)„P,lot?Plansr;(2)sets::dfsBuqtlfng�P-lans;'(1)`s�tof�Energy�Farms;;RiO�W'PermitifarnewainstrucUon, � ' <br /> ..... �r:Minfmum�ten�(�1A);utrarlting:,day,s;aRei;�subitiittal'ilate:�;R j utieii onsfte,xConstruc�oit4Pla'ns;•'Stoimwater Pians`wi Silt`Fence Installeii <br /> ,._ .. e� . w � <br /> ....�s_..,::.�..._., ..�.�_.;r,,.,...-.m.. . _ <br /> SanitaryFacllEtlesr&wl�dumpsker•�Si.te��IVorkFPermitfor_sutidiW�io�sAerge;project5='.y v'_":;:- � ` ' � <br /> Ci?MMERCIAL Atmch(3)`compl`eYe set's�of'9'uilding Plans plus a Life Safety Page;`(1)set af Energy Porms.R-O W Permit for new construiction. <br /> Minimum ten(14j worlcing days after submlttal date. Requlred anslte,Con�trvctton Plans,Stormwater Plans w/Silt Fence installed, � <br /> Sanitary Eacilities&1 du�ripster.Site Work Permit for atl new:projects:.Ali cammerclal requirements.must meet campllance - <br /> SIGNPERMIT AttacFi'(2)set's'ofEngfne@r:ed;Plaris:s4. ��� . . �- � <br /> "*'PROPEFtTY SURVEY requ3rad!or atl_NEW_constru�flon.. <br /> Directlons: �-,:t=' � , ' , <br /> Fiil out appllca8on carnpletety. ' <br /> Owner 8 Cantractor sign back of applicaUon,notarized � <br /> If over a25d0,a Natice of Commencement Is requlred. (AIC upgrade�ov�r�7500) <br /> � "=1xi',.i�;;: <br /> A�qent(for the confractor}cr'Pawer of Attoritay(Eor t}ie awner}would be someone with na#arized lattar from awner authodzing same <br /> OVER THE COUN7ER,PERMITTING --, �(Front of-Applicatlon•Unly)�� •~ <br /> Reroafs If shingles Sswers Service Upgrades AlC Fenc;es{PloftSurveylFogtage} <br /> Driveways-Not over Counter if on public roadways..needs ROW` �� • -- -�� _� � V-�- � -n-- �- �-5 � <br /> . ... ....: . :.....a .,: ____.'t -._ ; ; ..��. d„t, ,;�. ,., _ :. <br /> .7.L� . .tJ'".. ._�^i;. ' . " ' � . . ., _. � . .F�.`. .. � w'�*� <br /> ' ;;,`,< _, , :,,z��°.fi}'` -,.,ry�-3��;��._'t -�t �# . . �. � , ,. ,' . ::'*. . . n',,;, <br /> ' .,. ,. „ .:<,n. ;�i. - .*.,., ,.� ,..�. ,. -. ...� - . � . .... , . , - .-. „ ;' <br /> , __. -. ,. .. x. -c=.�;. .�._ <br />