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�, _ _ a_,��-�so-oo�o City of Zephyrhilis Permit Application Fax-813-780-0021
<br /> 8uilding Department .
<br /> Dats Eteaelved �(3 ?�,�,_ `j�y l �
<br /> ; �Phone�Contact�far�Permittin '
<br /> � •�T�
<br /> Owner's Name l! �L°��� � ,Pt S Owner Phone Nnmber ����
<br /> Owner's Address [�? �� � � �7� �'/�IL ���+�7� Owner Phone Number � �
<br /> Fee Slmple Tltleholder.Name I � � Owner Phane Nuinber � �
<br /> J . , �
<br /> Fee Simple Tltleholder Addresa !
<br /> �
<br /> Jd8 AbDRESS ����/ / %+'� C�?�. ��/ll.�$ LOT# C� �',
<br /> St1BDIVtS10N ' �� PARCELtD# �� �� ��, p��'� ���� ��'�
<br /> , (OBTAINED FR4M PROPERTY,TAX NOTICE)
<br /> WORK FROPOSED NEW CONSfR ADDIAi..T �,� SIGN Q �Q pENtQLISH
<br /> e. INSTALL � REPAIR
<br /> PROPQSED=USE Q SFR Q 'COMM � C,� �OTHER , .
<br /> TYPE OF CONSTRUCTION -[� BLO'CK ' [� FRAME � � 'STEEL Q _
<br /> {�
<br /> DESGRiPT10N OF WORK � E'S r �� J�'N '�'� lG� ��17Y1 D � � V'��
<br /> BUI�DlNG BtZE �� �-SQ`FQOTAGE � � ,HEt,GHT .���
<br /> QBUtt,DING �„ � � . ... _: . ..3.� , .._ >, „ . .
<br /> VAlUAT10t�t.t1F`TOTAL�CONSTf2UCT10N �
<br /> QE�EGTRiGAI � � AMP SEE�VICE �Q PRt?GRESS ENERGY Q W:R.E:C. ,�
<br /> „ , _
<br /> QPLUMBtNt3 =' t� � , -
<br /> QMECNANIGAL $ ���/.r? � VALUATlON OF MECfiANICAI INSTALLATEt?N
<br /> . � C, �j���. , . . _
<br /> QGAS Q R�OFING [� SPEGlALTI � OTHER� •
<br /> FIfVISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA �]YES. NO
<br /> ..,,
<br /> BUIl.DER COMPANY '
<br /> SIGNATURE REGI$TERED Y/ N FEE CURRE� Y/N�.
<br /> Address � , License#"� �
<br /> ELECTEi1C1AN� - �GONIPANY ` - . ,
<br /> SIGNATURE � REGI37ERED Y/ N FEE CURREK�' -Y/N �
<br /> Address - � _ , t .'llcense#.�, �
<br /> P�UCYIBER ` �I C{,1MRANY ' • �H -�
<br /> SIGNA7URE` ' ,.REGIST.ERED. Y./-..N, :rFEECURRE� � Y-/N; '� `
<br /> Addres8 ;LiC@ASB,.# � " + -, �,4'. ,:,
<br /> MECHANIGAl:" ` ' - COIMPAN1l ✓J`.����5 ,P�'l:,t�=�'C�t"t�"v�`'� d/�G�
<br /> SIGNATURE t'�� ' ' �"� ' REGI3TERED , Y,/ N ,� : ,FEE CURRE�, Y/-N = , .
<br /> � Address:� ���`f"C l�it} `� Il�G,�j �`�� : �cense# �t�+n4.tf�'��-S� �� ' �
<br /> OTHER '.. _ _ - _ , � ,. �;GOMPANY - � ,
<br /> . . , .� _ -�.. ,�;
<br /> .. � - ^7 . � .
<br /> StGNA7URE �R �ERED� Y . _
<br /> � EGIST / N.. FEE CURRE� Y/N
<br /> Addre�s ,, s' _ '?* � � ' l.lcense#�(" �`'�1 . .
<br /> i,. .. .. `ti_.r.�:;' 1^,: d:.�...�_.n�.;�. .<< • ' ,
<br /> RESIQENTIAi:�;• :Attacti"(2).P-.fot�Pians;_(2)sets�of'Bulfd€ng}Plans;'(�1)set of Energy?Fomts.;.R=O=W�Peririi't fo�new tzanstrtiction,.,
<br /> .. n. -_.. : ��. ;.., .. .- . �... ,. ,, .,_
<br /> ;;�Minimumtterr(�1,0)2wo.rking;days;after,:submitta{�date.=>Required onsite;.Can"stiuction-Rlans;•Stormwater Plans w/SfIYFence instalied,
<br /> i ""'� �SanftaryFadllUes,8��lp,durnpster-Site�Wprk:PermittorsubiliVisionsAarge.proJecM''::..�� ' ` � ° �` ' •
<br /> COMMERCIAt. Attach(3}�compieta sefs`of 8uiiding'Pians plus a�Life'Saifety Page;{1)set of Energy Farms.R-O-W Permt#far new constructian.� -
<br /> Minimum ten(10)working days after submtttai date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> � -- Sanitary Fadlides 8 1 dumpster.Site War1c Permit for ail new:proJects:.All commerctal requlrements.must meet complience' '� �
<br /> $!GN PERMl1' Attach'{2)sefs of`Englneer.ed;Plans.t, � - � . �
<br /> ""PROPERTY SURVEY requ(red for ail NE4'V aanstrucUon... -
<br /> Directions: ° , , ' '
<br /> Ffll out applicaUon completely.
<br /> Owner&Contractor stgn back of appllcadon,notarized
<br /> If over�500,a Notice af Cammencemen#i�requi�ad. {A!C upgrades aver;7500)
<br /> ,,.•,r,.,,.,:,
<br /> `" Agent(fpr the contractor)'ar`Power of Attbmey�(fo�tlie owner)would beMsomeone with�notarized letter from owner authorizing same ,
<br /> OVER THE COUN'fER PERMI'iTiNG -- -{Front of�APPtica�an Only) ' ,� - .. ..:. ,...- ,. .. ., .�,.;,,.R�..�.
<br /> Reroofs if shingles Sewers Service�,UPgrades A%C`�""F`�nces(PIoUSunrey/Faotage) • , ., ,
<br /> � Drlvewaya-Nat over Countar tf on pubiia roaduuays.,needs ROW � • � ' � ' . • `
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