|
813-780-0020 City of Zephyrhilis Permit Application Fax-813-780•002�
<br /> � . ��=%�
<br /> Building Department
<br /> Date Recelved . : Phone�Contact forPermittin ` �J ��� — ����
<br /> Owner's Name i �67 / ,��� / Owner Phone Number �/'`��d' �
<br /> Owner's Address , ���/ /a�/� � � Owner Phone Number
<br /> ' - ,
<br /> Fee Simpte Tltleholder.Name Owner Phone Number
<br /> Fee Stmple Titleholder Addresa
<br /> JOB ADDRESS � /�� ��x�^G(.� L, LOT# �
<br /> SUBDIVISION /!��/e ��KS PARCEL ID# G/J �� �f � ��' ���
<br /> , (OBTAINED FROM PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN' Q Q DEMOLISH
<br /> ;e, INSTALL � ..REPAIR -
<br /> PROPOSED,USE , • -� Q SFR Q 'COMM Q OTHER �
<br /> TYPE OF CONSTRUCTION - Q� �'BLOCK " Q FRAME ° � STEEL Q
<br /> DE�CRIPTION OF WORK' F /\L�S� � C �jQ-/�f !��'�j(,(� � �.'YllYI � G/�'�. � �/�
<br /> BUILDING SIZE - ' SQ FOOTAGE ' , ,HEIGHT �.
<br /> QBUILDING $ VALUATION�OF TOTAL CONSTRUCTION � " '
<br /> QELECTRICAL $ ' AMP SERVICE Q �PROGRESS ENERGY Q W.R.E.C.
<br /> OPL•UMBING '$ -
<br /> QMECHANIGAL $ ' VALUATION OF MECHANICAL INSTALI:ATION
<br /> _ ��� . � ..
<br /> QG�4S Q ROOFING .Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. ,NO
<br /> � - ,,
<br /> BUILDER COINP"14NY�
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address ' Lfcense•# �
<br /> ELECTRICIAN� ,,. �, � � :?COMPANY -
<br /> SIGNATURE �` REGISTERED Y/ N FEE CURRE� � • ��Y/N'
<br /> ,;, . _ , - - . ' . - .
<br /> Address � � .�� License#=.°�
<br /> PLUMBER ' ' COMP,ANY_, �� � '
<br /> SIGNATURE '� ' ' � ;. REGISTERED� : Y,L•N.. :: ••FEE Ct1RRE� ' Y•/N �
<br /> Address � License.# • �
<br /> MECHANICAI:" 9I�/`��p a , �A . C.OMP�ANY �s �' ���`t$��� ,
<br /> SIGNATURE - �K'+���"C wL.� _ `' REGISTERED � � Y../ N ,FeE CuwtEn- . . Y,/�N � ,
<br /> Addre�s~��-� I l� ' � �/f/LL�.S . , License# .�Yo �3 L. �
<br /> OTHER , . , ' - : ` , �. ";COMPANY
<br /> SIGNATURE •� 4=�'`'�•'z' � � ' �'' ' ' ' ' �"REGiSTEitE�` Y/ N;,- -:FEECURRE� Y/N
<br /> Aeldr�ss� . �>. .. �{ /- . "` - Gcense#`' ' � , .
<br /> ,..,; .. . �., ti,:-,.•.::.> �. � -
<br /> RESIDENTIAL?;� �Attacti;(2).PIot�P,lans;:,(2)'sets::of�BulldfngiPlan`s;'(1)setofEnergy�Form's;`�R=O=W<Permitfornew=conshucUon, " ".
<br /> ;;:Minlmum�Ften�(1.0)�working�days;akerrsubmltfaf date:',R'equlred onslfe;'Con`stiiicdon Plans;Stortnwater Plans w/Sllt'Fence installed,
<br /> __. � ��-�;�Sani'EarjiFaclltUes,;8�R1.dumpster�.Slte�_Work,�Permitforsubdivislons/large_pro]ebts;�.__,' :• . ' � �
<br /> COMMERCIAL � Attach(3)complete sefs of Building Plans plusta Ll'fe'Sefety Page;(1)set of Energy Fortns.R-O-W Pertnit for new construcUon.
<br /> Minimum ten(10)working days'after submittal date. Requtred onslte,ConstrucHon Plans,Stormwater Plans w/Sflt Fence Installed,
<br /> SanlNary FaclliUes 8 1 dumpster.Slte Work Permlt for all newtproject's:,All commerclal requlrements:must meet compllance
<br /> SIGN PERMIT Attacfi"(2)`sefs of�Engineered�Flans::: r , �
<br /> << . � •.
<br /> ""PROPERTY SURVEY requlred for all NEW,conshucUon. .
<br /> Dlrectlons: • �• . ' �.� � _ - '
<br /> FIII out appllcaUon wmpletely.
<br /> Owner&Contractor slgn back of appNcatlon,notarized � '
<br /> If over 52500,a Notice.of Commencement Is requlred. (A/C upgrades over 57500) ����;,�,.;.,�-:�,,,�,�,.;�„„��,,,,��;r�;_.:_..•;:.,:,
<br /> :., ��...;
<br /> " Agent(for the�contraotor)'or'Power of Attomey(fo�tlie.owner would be soineone with notarized lette�from ow�ier authoHitng`same -• ��• ;;
<br /> lADau"T.�`�.'�'.y�`:�kt�.f2''w+fi°�^_^�'w1e'-Jr:�° ��iiii,l:)�:i a4�:.i� � i�it. . , _- `
<br /> DVER THE COUNTER,P�RMITT((��;`�-. �(Front;of-AppllcaUomONy) � � � � ,t:� �,> �,� .�- , . •`, j' I
<br /> Reroofs If shingles Sewers -i�-,�;ti�e`r'vice'Upgr'ac�es A/G-% �''�Fences(Plot/Survey/Footage) '; ,,:�{,r.;; ; , , ''- !; _
<br /> f_L;Y�:+�i .:�� „< < ,-'. :.�_. s,.: . -- _. .
<br /> � t= . , t,';,s :o
<br /> __ '_ "z6� ' ���. � - .— � �r �iYi. ,� :..3-t `.r;„�� -�'C S . l,!a�`.'z� :,. . . , �� , � .�'
<br /> Drlvewaya-Not over Gounter if on public roadways..needs ROW�:' �' �;>��: ,. � - -_ - . _ ___ _ .
<br /> , , �. , ,i.r.... , q�:w^. , . . .
<br /> Y1� ' , , _ �, �— .
<br /> . • 1
<br /> {
<br /> ,' I
<br />
|