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<br /> ` 813-780-002Q City of Zephyrhiils Permit Application Fax-e�s-Tea-ooa�
<br /> 8uilding Department
<br /> Date Received :��"..r?i�:/j °g� r.�n��.',i;i_,sg,;Usr;r:,i:�='"-';na�:w�'' ,_.;'M_',
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<br /> Owner's Naime ._- "' .�
<br /> �virrier Phone.Numtier': - . �
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<br /> Owner'sAddress 3b`'��,�J. S� `�3��"� �"1 �''►t�15 � 3 t GwwrEer`�Ptio�eN �`'' `
<br /> r n uifilier
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<br /> Fee Slmpte Tittehatder Name Owner Phone Number
<br /> Fee 5imple Titleholder Address
<br /> JOB 14�DRESS LOT# ��
<br /> SUBpIVIS10N ��`� � ` ��"�"� PARCELID#
<br /> (OBTAINED fROt+'1 AROPERTY iAX NOTICE}
<br /> WORK PROPOSED � NEW CONSTR O ADD/ALT �] SIGN Q Q DEMOLISH
<br /> INSTALL Q REPAIR
<br /> PROPOSED USE Q SPR [� CC1MM � OTiiER
<br /> TYPE OF CQNSTRUCTION Q BLOCK Q FRAME �] STEEL Q
<br /> DESCRIPTION OF WORK Iy�W C�i`1�}ruC'Tl�Jl'�.- � �l.l�-�"�! - ��I
<br /> BUILDING SIZE � � 3Gt FOOTAGE 1��� � HEIGHT ��
<br /> BUiLDING $ �ZZ�C7�cS �,� VALUATION OF TOTAL CONS7RUCTION
<br /> �El.ECTRiCAL $ s �..,b— � At41P SERViCE Q PRO�RESS ENER�Y [� W.R.E.C.
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<br /> Q P�UMS{i�t� $ C,���O$ ��
<br /> �MECFiANICAt $ �_�.� .�,.����..� VA�UATION.C?F(1lIEGNA[�SfCRI.tNSTALLATlON
<br /> QGAS � ROOFING Q SPEGiAI.TY � OTHER
<br /> FINISHED FLOOR EI,EVA710NS ��� FLOOD ZONE AREA [�YES NO
<br /> BW[.DER .,�,y,, _ � GOMPAi�tY h�t C.bCLS'�t�C�C�-t ;�'1�.
<br /> SIGNATURE __ ��J REGI3TERED Y N FEE CURRE� Y/N
<br /> Address �(o;{(� Si'L. 5�{� �h rh��li,�+ �, �✓35L4{ ticense# �`�= t5��t`!'�� 1
<br /> EtECTRIGIAN � COMPAI�IY �5� !"GZS� �i+�P'�G
<br /> SIGNATURE REGISTERED N FEE CURRE� N
<br /> aaar�ss Ib�ii C�r+�er-ti� 2d, t�� � ,� 335z5' u�ens�# �^� �
<br /> PI.UMBfR `�`�� t COMPAtaY ���5 �1+�►'►bin9
<br /> SIGNATURE REGISTERED Y N. FEE CURRE� J N
<br /> Address �`� �+�e{� f�y �Jh rh i t(S� (z. 335'f f t�cense# �� i�Z'��f t S �
<br /> MECNA411CAL COMPIRNY SOnI� S �G
<br /> SIGNATURE REGISTERED Y/ N FEE CURREM1 Y J N
<br /> Address ��bs, �- �W .�a1 �� � ���� License# l�fr�?� j�7/�'f��O d �
<br /> QTHER COMPANY n �'� r� � -��'
<br /> SIG�lATURE REGI3TERED N FEE CURRER (\I
<br /> Address ���'�� Sj'�- 5y h �����s FL- 335W 1 License# �C`-�-�= �3 Z�S�' �
<br /> i1i111111t1I111i11111i1iI111I11111i111i1i1111i / 111111111illilllilii
<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set af Energy Forms;RA-W Permit for new construction,
<br /> Minimum ten{'!0}workirtg days after subm[ttal date. ftequired onsiYe,Constructton Pians,Stormwater Pians wJ 511t Fence Instailed,
<br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisiansliarge projects
<br /> COMMERCIAl. Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimus»ten(10}woxking days after submittai date. Required ansite,Constructtan Plans,Stormwater Pians wl Silt Fence instailed,
<br /> 8an(tary Facliities 8 1 dumpster.Site Work Permit for all new projects.Ail commercial requirements must meet comp{iance
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans.
<br /> :•"•Pt20PEt27Y SURVEY required for ali itlEVlt construotton.
<br /> . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . , . . �._ �._.s_._.�. ..�.._,_,
<br /> Directions:
<br /> FIN out appilcatton completeiy.
<br /> Owner&Contractor sign back of appiication,noterized
<br /> if over$2500,a Notice of Commencement is requfred. (AIG upgrades over$7500) ,
<br /> " AgeM(far#he contractar}or Power of Rttarrtey{far the owner}would be someone with notarized Ietter ftom awner authorizing same
<br /> OVER THE COUNTER PERMITTING (copy af contract requfred)
<br /> f2eraats if shJngles Sawers Service Upgrades AJC Fences{PtaVSurvey/Footage)
<br /> Driveways-NaR over Counter if on public roadways..needs ROW
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