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<br /> e�3aao-ooao City of Zephyrhiils Permit Application , Fax 813-Tap-0021
<br /> Bullding Department , .
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<br /> Date Reaetved l�—j' :�`� ;�: Phone Cantac#�far-Rermitt�n , .{31� � � - �
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<br /> OYvner's Name � �� !��� �,., -Owner Phons�Nurrif�er ' L"J� ,�Z ���
<br /> Owner'sAddresa � �� �� � •� • Owne�.PhbnsNumber
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<br /> F�e Simple Tltleholder�Nam� �� � � Owner Phone Number -'�
<br /> Fee Simple Tltleholder Addresa
<br /> JOB ADDRESS � � r � - ,•,� LOT# ��
<br /> SUBDIViS10N �- � ` P.ARCEI,ID# _. • �
<br /> � , - • (O@TAItdED:F.RfJM PROPERiY,-T11X NOTICE�
<br /> WORK PRQPOSEp �.NEW CONSTR�' ADDIAi:T �� Stt3N' '�] [� DEMOLiSH
<br /> - ,.. �.;e. INSTAI.I.. � c;,:REPAIR -• ' �
<br /> PRCIPOSED,USE . , Q SFR. �. 'COfUI(titl' „�� �OTF{ER' � - � ` �
<br /> TYPE OF CONSTRUC7'ION' _�� Q�' "'BLOCK " �C] FRAME _� ;STEEL Q
<br /> DESCRIPTION OF WOItK �'` �� � ���F` i�'V' �j�Geti'�rt�,,,�CJ
<br /> SUiI.D1NCi;SFZE ,� � ' , �.SQtFOOTAGE��;.... ...HEjGHT��. � . � .
<br /> �����t��`' $ � VA4UATION;OF�1'OTAL CONSI'Rl`'1C1'101V r� ' " " -
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<br /> QE���jR���- $ . AMP SERViCE Q 'PROGRESS E�lERGY ,Q W:R.E.C.
<br /> QPLt1MBING. ;$ � "- �Z�
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<br /> QMECHi4NlGAl $- VI�t.UAT10N OF MECtiANICA�IPiSTALtA.T10iV. � I�
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<br /> QC�AS Q ROQFI{VG _Q SP,ECIALTY. � QTHER:
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<br /> FINISHED F1,00R ELEVATIQNS . FLOOp�ONE AREA QYE$. ,NO ' �� � �4C�'�i+"-
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<br /> 8UEl.DER � MPi�Y�� � � C�. �.
<br /> SIGNATURE R REGISTERED Y/ N `FEE CU En � Y/M �
<br /> Address ' Llcense# I,t�,,� (7 , .�y lJ I
<br /> �IECTRIC,lAiV- ,_ , - ° ,;C'O11A�ANY ' ' . - .
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�°a 's'��Y/N' °
<br /> ,�ctalress , . , - ` _ � ,� , _ Ucense�#��,� - �
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<br /> SIGNATURE'" " '`'` ' ' _ -,REGISTERED. , Y./r N• a'FEE•CURRE� Y/N
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<br /> SIGNATURE: � � • � � � � t " � `" REGI$TERED , Y./ N FEE CURRE�; Y:/�N
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<br /> 'RE�ISTERED Y/ N::. �FEE CURREA Y/N
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<br /> .lalisif,2� "sets=of`B'ItilEn t lan $ �' `" a 'JF '�sr.� ,`,
<br /> Tl�t.�;�';:., "{ )µ ,� } = u g.P 's;(1}'set ofriEn'ergyi{Forms;�R=O-{N�Permif#6'rrtew caiisttuc�on, . ,
<br /> "'-,�:��,',s Minimum�tep�(1.0),working�dajis aftia��;subiniftal'deCe:�R�qul�ed onslte;:Co`n'atru�Uon`Plans;StoPirNwater plans�w/Stft Fence lnstalled,
<br /> Sanitary Ferd�litles;,&1r,dumpster;;Slte�Wo�lc�Pemlitufcr sulidivlsloiis/largerpmjscts',:_�r;::x�� : - -- . � . �
<br /> COl�IM�RCIAl. Aftach(3j`comptete'sets of Bullding Plans plus a.U€e Safety Page{1)seE of Energy Fotms.R-Q-W Permtt for netiv constru�Uon. � �
<br /> Minimum ten(10)woricing days afker submlttal dete. Required onsite,ConstrucNan Plane,Stormwater Plans w/Sflt Fence inst�lled,
<br /> Sanitary FaciltGes 8�1 dumpster.Slte Work Pemtlt for all newtprojects..All commerciaf CeAutr,ements_must meet comp{Isnce ' �
<br /> wSIGN°P£RMIT Attaofi{2)`sets af'Englnee�;Pla�ns:*~r�.�;~�s:_,-r :;:;;:- �.. . � .
<br /> ••`"PROPERTY SURVEY reyuired.for all NEW.`canstruction... _ __. .... ..
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<br /> ,.Dlr'ectlons: :�-t1�...,_ `-c•� .� . . .
<br /> Fill out applicaUon completely.
<br /> Qwner&ContracMr.stgn t�ack of appficaUon,natadzed �
<br /> !t`over t��00,�Natice of Cammencement Is required. (AIC upgrade�over 37500j
<br /> �. "i::_'g 1�5F;�.�t'"vy. . '
<br /> AgenC(far the cbntractor)+ar`PoWer'of Attamey(to�the owner)�would tie someone w[th�notarized Ietter trom owner authorizing same
<br /> -�DVER=THE CdUN.T.ER.PERMITTiNG-��-�(Frontaf ApplicaBon•Oniy)�-- �•- - ` ` '
<br /> Reroafs if shingles Sewrers Service Upgrades A/C Fe�ces(PlobSurvey/Foatage)
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<br /> Drivewaya-Nat aver Counter if on public roadways:.needs ROW" ` �
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