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a�saeaoo2a City af Zephyrhilis Permit Application Fax 813-780-0021
<br /> BuEfding Department
<br /> Aate Reaetved � �� ; Fhone�Cot�tact�for PermNtin
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<br /> .�\' . . . , . �a3 � y� -.�y� �
<br /> Ovrner's Name ^�.� G f2 Ownar Phone Numbe�
<br /> Owner's Address � � V � V'��� �'�L `�C� Ow�er Phone�Number r� �-
<br />' Fee Simple TlNatiolder.Name � Owner Phone Number `� �
<br /> Fee Simple Titleholdec Addresa
<br /> JOB ADDRESS � '��^�, �S �" � LOT# ��
<br /> SUBDIVISiOt�t � � - PARCEIId# �
<br /> , , (OBTAINEq FROM PROPER7'Y TAX NOTICE)
<br /> WORIC PROPOSEQ NHW'tOi35TR ADDIALT �` SiGN` [� " Q DEMOI.ISH
<br /> �e. INSTALL �� , REPAIR
<br />, PRQPOSED.11SE- � Q SFR Q � CQMM - C� •QTHER ` ' ' '
<br />� TYPE OF CONSTRUCTION ' Q BLOCK " Q FRAME Q STEEL Q
<br />( DESCRiisTION OF WORK Y ���PS) r, G d uQ�.-�.. (� (',� ;
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<br /> I BUILDlNG SlZE C� ' �'SQ�fOOTAGE���. ; ,;.HEI,GFIT.,f���
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<br /> 0����'p���' � � 7 ��� VAIUAT'IOttil;�}F`TOl'AL CONSTRUCI'ION
<br /> QELECTRIGA� , � � AMP S�RVIGE Q PROGRESS ENERGY Q W:R.E.C. �
<br /> QPLUMBiNG � ;{$ � ' ,
<br /> � � � �����.�..��-
<br /> '� QMECNANtCAL $ ` VALUATION OF�MECNRNICA�INSTALIA�fQN� �
<br /> QGAS Q ROC?FING _Q SPECIALTY �] C?THER� �` ��� �
<br /> FINISHED FLQOR ELEVATIONS ��� FLQOD ZONE AREA [�YES ,NO
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<br /> BUEE.DER `� p71NY� . .
<br /> SIGNATURE f REGISTERED Y/ N FEE CURRE� Y/N-'
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<br /> Address • Ctcense# i ` ' ��
<br /> ELECTRICIAt�l: < C'OMPANY� �
<br /> SIGNATURE � REGISTERED Y/ N FEE'CUF2REK� 'Y/N
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<br /> AddrB� ` � , y LiC@i'iSe�#�:�,
<br /> #�LUMBER" , , , COMP.At+lY-• ,� ° ,
<br /> SIGNATURE ' ' REGISTERED Y L-.N,a ;� -..rFEE CU,RRE� Y-/N. • :, .
<br /> Address �_ ..Ltcerise�.#�(.,. � , • .�.
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<br /> MECHANlCAF: _ ' � COMRA[+lY. � •
<br /> SIGNATURE "' ' REGISTERED X,/.N . ,,, FEE?Cutt�tEn Y./�N , �
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<br /> Address,= - , • . .- ` . � • " License# � - 1
<br /> OTHER : - � � `,GOMPANY, �
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<br /> SiGNA7URE � • � �'' �� � ` r ` REGI3TERED" ' Y/ N.., � FEE CUR12E� � Y/N.
<br /> � Address ' . ' � � , _ ' - � - Liceiise#�� � - . `� � .
<br /> ' �n.p.,.J�I. ..,� ..����.,M1: �, e�� ' �.r. ��S�,r .: � '
<br /> RESIDENTIAi:.° _ :Attach"{2}!PtotP.,lans;:(2}sefs=of�Buitdlrig�l?lans;`(1}'set of-Energjr�Fanns;�,F2�W'Pei�cilE fbr new constructlon, - '"� _ � `
<br /> - •�Minlmum�;ien°(1.0)�working,cSays;aiter,:subriniftal date�`�,Required onsite,:Con'"strucdon=Ptans;`Startnwater Pia�s w7 SIIt Fence installed,
<br /> ."���.SanitaryFacitttl,es,&t.1,�dumpstert�Site•Wor1c„Permit:forsutiilivisions/large,:projecfs'?--,; :;� � . ' •� '.��:� `
<br /> COMMERCtAL Attach{3j complete'sets`of Buildiog'Plans pius a�l.ife'Safefy Page;{'f}set af Energy Forms.R O-W Permit for new constnsefion.
<br /> Minimum ten(10)working days�after submittai date. Requlred onsfta,ConstrucUan Plans,Stortnwater Ptans w/Silt Fence lnstalled,
<br /> Sanitary FaciliUes&1 dumpster.Site Work Permlt for all new:projects..All commercial requirements must meet compliance `
<br /> $!GN PERMl7 Atta#i{2}sets ofEng,l`cieeredLLPlans..:,.,.:�,- �-. . ,- - ,
<br /> •"`PROPERTY SURVEY required for ail.NEy'V construcd'an. - - ,
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<br /> � DIf8Ct10DS: ` . , " . ,' ;
<br /> � Fill out applicatlon completely.
<br /> Owner 8 Cantractor sign back of appltcadon,notarized
<br /> !f over�25Q0.a Notice af Cammencement Is required. {AtC upgra@es avet ST500)
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<br /> `" Agent(for the con6ractor)or Power of Attbmey�(far ttie owner)wauld be someone with notarized letter from owner autho�izing same
<br /> OVER THE C�UNTER.PERMISTENG .. (Frant af Appllcation Oniy) _ ,
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drlvewsys-Not over Counter tf on public roadways..needs R8W
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