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<br /> �„-'��"UU2� City of Zephyrhiils Permit Application Fax-813-rsaoaz� r
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<br /> ; Building Deparfinent . �
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<br /> Date Received ' . �� ,. .. phone�ContactforP��mtttin - .S J�ca� f -- �` ��� - �
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<br /> Owner'a Name 47^�- qwner Phone Numbm�r � c2G�t�p�.. .'' '
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<br /> Owner's Addres� O a�� Owner Phona Number� � � � �
<br /> Fee Slmple 71Neholder Name Qwnsr Phone Number �:
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<br /> Fee Simple Titl�hoider Address i
<br /> S08 ADpRES$ �} � R�C l/,.� � t�OT# �_� �
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<br /> suao�vis�o� � � PaRc��..�a;� ��2 r.,?�O c� O O I� � Q� 4 Q - t i
<br /> � � : (OBTqINED F.ROM PROPERTY'TAX NOTICE) �, �
<br /> WqRK PR�DPOSED ,:NEW CONSTR AQDlALT ��' SIGlV Q Q DEMOLISN �, �
<br /> , INSTALI: ,8 .' .REPiAtR .� . . �
<br /> PROPO$ED�USE Q SFR� [� GOMM � •OTHER � '
<br /> rnis o�cor�s�rtucnot� [Q� � e�ac�c " Q PR/iME � S't�EL Q ;
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<br /> DESCRIPTtON{�F WORK � t ; �! ,/, J'� U �O� y
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<br /> BUILDfNG SlZE"" "SQ FOQTFiG�E ' HEtR"sFlT�{.�� '
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<br /> QBUILDING �__-_�� VAlUATlC}N�OF'1''�OTRL'"COPISTF2GGTit?N Y �
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<br /> QELECTRICAL. �� • AMP SERVICE Q PROGRESS ENERGY I
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<br /> QPLUMBING .$ +
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<br /> [�MECHANIGAL $ ����/. VACOATION OF MECHANICAL INSTALLATION F
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<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER �
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<br /> FIN{SkiED F�OOR ELEVATIONS � 1� FIOOD ZONE AREA QYES. NO �
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<br /> 9UILDER ���PpN.(,. . i
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<br /> --- _ __ _ �._. - - -REG1SiERED' "` Y/ hl—'a-"�FEE GURREP " Y'/N ;
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<br /> AddreSs ' - �
<br /> �icense#'� � `
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<br /> El.ECTRICIAN � I . �' . ' r=GOMPANY ��r>.S''-� ;/� Ci�• c �
<br /> Sl�aNATURE �°-� � � R£GISTERED Y t N FEE Ct7RREt�"; , :'y J '
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<br /> Aadres's !��v�-" s � 3 C�•/ , ,- tJcense#��`�'/_3 (YU r"�� £��
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<br /> PLUMBBR � � COMP�INY
<br /> SIGl+L4'�{,1RE` " >-:REGISTEi2EQ,. - Y.1:N.; :., f--,���cu�� - Y-1 N. � � ,
<br /> Address . .Elcense.# �. - , �.
<br /> MECHANICAI: . , ' COMPANY � lC... '
<br /> $K31�t14T1.1RE • REGISTEf2ED Y N . . `� PEE GURREh l N
<br /> Address � �Gi� ' � Ucense#� f .�,��7��. ��� �
<br /> 4THER ' - . � - ��COMP,ANY~ , 5' �
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<br /> SIGNATURE �.3 � . . ,� ,FtE�iszFtt�o' ` `T! N::: _ �E�CtiR�t�R`. � Y!N
<br /> Address _ - .� e ., ... , ;, .. .,. Ucen"se#�(� . , �
<br /> RESIDENYIAL;; :AttacliM�,Pl Plan# '" d , . "� ', . ;. 6�x.:_ :� �;;. �n�-. ,,:� , . '
<br /> (. ); ot� s,:(2)sets:ofiB'uflding°�plansC'(1)'sefof�Energy�Forms�;R�C1=W�Periinit�fornewconstructlon,,
<br /> :;. .,,�:Minimum�ten�,(�!0}�u�orlting,�ays>after�sutiiniftaliiafe:�.�equlc�id onsite;'Goiisfnai;Hon::Plans;Stoimwater Plans w!S11t-�ence instaliea.
<br /> l-� Sanilary Facltltles�&a'�;=,dumpster��8lta WorkaPermlt�,tor.;s,ub`,divlslonsAarge;projecfs�-�;.y`:��;;;` _ . -
<br /> COMMERCIAL Attech(3)�oomplete�sets of 9uilding Plans plus a Life'Safety Page;`(1)set of Energy Fom►s.R-O-W Rermtt for new'consiruictton. -
<br /> Minlmum ten(90}warking days after subirilital d�te. Required cs�site,Construction P1ans,Stannwater Plans wl Sil#�encs tnstalted,
<br /> Sanitary Faciiitles 81 dumpster.Site Work Permit,for eli new�projscts.,.All commerGal requlrements,must meet compllance � �
<br /> SION PERMIT AttadYi(2)sefs ofEngJiieere.drF±la.'.n.'s:, 5.-----�`-� .-.�'._, .. � '
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<br /> •'°,Pt20PERTY SURVEY �ulrec!fot a[!.tdEW_construcHon..
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<br /> Directions: � ,,. - . � . '
<br /> F�11 out appllcatlon completely.
<br /> Owner 8 Canhactor slgn back of applfcatlon,notarized �
<br /> If ovar�2500,a Notice of Cammencement Is requlred. (A!C upgrades over$T500)
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<br /> "' P�qent(for the con6ractor)ot'Powe�of�Attcritey(for ttie owner)�woulii he someone with notarized le#ter from awner authorizing same
<br /> fiVER THE COUN.T,ER PERMIT�TING- --- •(Front of-AppllceUon Only)�� -
<br /> Reroofs If shtngtes Sewers Service Upgrades AlC Fences{PlofilSurvg}rlFootage}
<br /> Driveways-IVat over Counter if on public roadways..aeeds ROW�
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