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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 . �
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<br /> Date Recalved ,. ,, phone=Conta�ct'forPermittin ;
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<br /> Owner's Name � f C�� Clwner Phone Number �� ' �S C� ��,i��b` �
<br /> � �VP . ;
<br /> Owner's Address �J � Owner Phone Number � � �
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<br /> Fee Simpl�Titleho(der Name � , �� Owrier-Phone Number ` �`
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<br /> Fae Stmple TitEehotder Addr�ss j
<br /> d08 ADDRESS �{37'# �_____� �
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<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 ; . {
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<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�
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<br /> BUILDlNl3"SIZE`'. . SQ FQOTAGE�i - ,,HElGHT� . �Y 7C �" ! �
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<br /> �BUILDING $ ���� "
<br /> , `�-�... VALUATION`OF't'OTAL"GfaNS�'RIJGTION" t
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<br />, QELECTRICAL �� AMP SERVICE Q PROGRESS ENERGY [� W.R.E.G. �
<br /> QPLUMBING ���� � �
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<br /> C]MECHANICAL $ VALUATION OF.MECHl11JICAL INSTALI:ATION s
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<br /> QGAS [� ROQFING :Q SPECIALTY Q 07MER ;
<br /> FINISNED F�OOR EI.EVATIONS � � F�OOD ZOEtE AREA QYES. f�t0 i
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<br /> 9UILDER '���^*�� C�MPANY'' � C�1..+-�`r'�"e- 'C� i
<br /> StGNATU#tE ��� �V { REGIsi'EREo Y t C+! . " "F�E CURREh Y!N !
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<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 ;
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<br /> Addre�s ' , - � . - - License:# � � � '
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<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�
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<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#`� �-
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<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
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<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 �
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