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B�Saeo-ooxo City of Zephyfiills Permit Application Fax 813-780-0021
<br /> Buftding Oepattment
<br /> Date Raceived , :.;a p�hane�Caotact�fOT�ParmEttln ; - � ..
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<br /> Owrner's Pl�me ���( �'e Owner Phone Number "tJ��-�
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<br /> Owner's Addresa � � �� >: �� � Owrner.Phone Number �
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<br /> Fee Slmple Titfeh'olderName ' • ' �' Owrier Phone Number
<br /> Fee Simple Tltleholder Addra�a �
<br /> J�B 14DdRESS ��` � � � L07'� ��
<br />� SUBDIVtS10N � . �� r pARCEL I�# � °
<br /> • , , „ �OBTrA�NED FR�SNtl PROPERTY.T/1X NOYICE)
<br /> WORIC PROPOS�D, _::NEW-COt�5TR-'. ADDlA1:T ��� StGN' `Q- • -[� DEMOLISH
<br /> ,. ,_',e. INSTAI:L .8, .�;;..REPAIR
<br /> I PROPOSED.USE .- . �. Q� SFR; � �GOMM , �`[� �QTFiER' - ' ' '
<br />� TYPE OF CONSTRUGTION' Q� ''BLOEK ' C] `FRAME �� 'STEEG Q _
<br /> I DESCit1�TiON,OF Wr3RK. ,`., . ��� C �1�4� ,
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<br /> �li1CpING:SI�E '-�_ ` ' � SQ'FOtIiTAGE ''17-'7 ;: , .�HEIGFiT . ��..__c_.�
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<br /> �8������'' $ �6 VAI.UATiflN:tOF�TC}Tf►LCONS7'Rl``'IC�ION'f � "
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<br /> [��i.ECTRiGAI. ; ,�$ � �MP SERVECE Q 'PROGFtBS3 ENEi2GY Q W.R.E.C,
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<br /> Q � � VALUATION OP MECHAt�11CA1 fNSTALi:A,71t?N � ,�}
<br /> hAECNANlGAL $ '—_f.. , . f �
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<br /> [�GAS C] F2QOFIt+RG -Q SP.ECIAL'iY [;��'] QtHER�� �� o , /
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<br /> FINISHED FI.00R ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> �tdi�DER � COMRANY� = �Y�� �(!1 c.� .
<br /> SIGNATURE REGISTERED Y/ N ' FEE CURRE�-' - ` Y/N�.
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<br /> SIGNATURE^ '' REGISTERED Y/ N FEE CUFtRE��� "'� "Y/Id`' ` '
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<br /> Addre�s ' . { . • . - � ' � . . - License=#��::=,.!^ Y �
<br /> PLUMBEl�' ' ° . . - GQMPANY. . ,, _
<br /> SIGNA7URE;: .... :;. .. • . . , �:�. , _„ � ..;: �.
<br /> _ REGI$TERED, Y.L�N,= ,FEECURREA Y/N.
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<br /> SIGNAT�RE� . _ , .. �' REQISTERED,a� ,.Y.../.N. � ,n2:FEECURRED._ Y-IePd'.- _ .
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<br /> SiGNATU(tE" .':�` .4r ` ��t� � , - • �''` ` 'REGI$TERED�� . Y I AM. 'FEE CURREP � Y/I1�.
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<br /> Addre�s �.��.,. ..�'.'-,., _�: �t �
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<br /> �RE8tDENT���°;{';Attaicl�;,(2j Rtct:t?latis;;.(2)s+�ts<of�8ulltling�'f?laas;{`1)'seta!'nEnergy�Farms,°R=�=VY°Peimlt fornew°i�nstriic;tton,.
<br /> y.. A..._,i..e..r A�'>.�°"'...y ,^f��:.7.a...r St^�,+
<br /> �•-�„-,;��,y�:Minimu,m�ten�(�10);,wo;rkle�g�,;dajis;ait'er,�"subiniffal"dafe.�Requiretl cnsife,.GonstiucNon�Pia"ns;:Stoimwate�°Plans•w/Si(t�Fence instailed,
<br /> . „ Sanlfary FadllUes&1�du,mpster,pSite W.o,r�k�Permft�fo�rsu�dL`vislo�s/Iarge�Rmlects;y`..r;;;`.�,`,. ���� �` ;;- : -',�� ,: .;:N . .
<br /> CONIMERC9AL -Attr�ch{3)ucoriiplet�`sets of Biilttlliig Ptati"s pius�l.ife.Safeity`�Page;(�}set cf Eiiergy Forms.R tI-W Permit#or new canstru�tibn. �
<br /> Minimum ten(10)woricing deys after submithal date. Required onsite,ConsUucUan Plans,Stortnwater Plans�v/Sflt Fence fnstalled,
<br /> Sanitary FadliUes&1 dumpster.Site Work Permit for all new<'proJ�cts:�.All commerclal.fequlr.em�nts_must meet compliance
<br /> ( ,.;SiGN PERMIT A#kar.�°{2)sets af`Eiigti�ee�;od;;Plans., . . .�Fs2 ,�,f v:° . �
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<br /> "•"PROPERTY SURVEY requlred for alI NEW.aanshucd'an.,,.... .,._,.__... -.- ,
<br /> .,�}I!$t'tr,IQ118: .=r:��.�.._."e=': ,� _. , _ . . �
<br /> Fill out applicatlon complekely.
<br /> Ownar&Contractor-slgn back of appl[cadon.notartzed �
<br /> ff ov�r 5�0.a.Ptotice ot;Commencament Is r�quired. (A7C upgrades aver 57500) _., :
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<br /> AgenC(for the confractor)�or"Power''of Attortiey"(for`tlie'ovirner)'would�tie someone with nota�zed letter from ownar au4ho�izing same _
<br /> ' °OVER-THECClUN'�F�<PE�MI�i't1t�Q._..-.�,.(FrontofAppllcatIon�Oniy)•_..._ _. . ..-`> .
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) _
<br /> _:.,-a�,:...:�:- ��•-.:=•�.,�� • . . N ..
<br /> Driveway�-Not avar Caunter if on publia roadw+ays..need`s ROW h
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