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813-780•0020 City of Zephyrhilis Permit Application Far•813-780-0027 <br /> • Building Depanmeni ' <br /> Date Received PlYone Contact for Permitting ( � <br /> � r� � � � � � _._Ll.1J_L_ � � ri � �_ . _ J_t <br /> 7 �7 <br /> Owner's Name � `�'� � Owner Phone Number ��� et��� S <br /> Ownar's Address ��/ 0� �/U �s�'C D��� Owner Phonc Num6cr <br /> x Fee Simplc Titleholdcr Namo � Owner Phone Numbcr <br /> XFee Slrnplc Tlticholdcr Address �— <br /> JOB ADDRESS 56�3 � '�NP p��� z�h /��J�/�f �'�� LOT# � <br /> SUBDIVISIOtJ PARCEL IDp <br /> 106TAIHED FftOM PROPERTY TAx NOTIGE� <br /> WORK.PROPOSED e NEVJCONSTqB ADDIAIT � 31GN Q I �cy� DEMOLISH <br /> INSTALL REPAIR T <br /> PROPOSED USE Q SFR O COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK I,�ErNU B�T S/"T�• <br /> BUILDING SIZE S�FOOTAGE� NEIGHT � <br /> QBUILDING 5 VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL S AMPSERVICE Q PROGRESSENERGY Q W.R.E.C. <br /> OPLUMBWG $ ' j, r/y���� <br /> �ij'�(J <br /> QMECHANICA� $ VALUATION OF MECHANICAL INSTALLATION � �• <br /> �GAS Q ROO�ING Q SP[CIALTY � OTHER <br /> FINISIIED FLOOR ELEVkT10NS FLOUD ZONE l�REA QYES NO <br /> BIIILDER COMPANY T� �� ,S�/c'i�U�'V <br /> SIGNA7URE REGISTERFD Y/ N FEECURRE� Y!N <br /> Address � Svn.JT� S/ Liconse# G.(� �SZ I6 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTEREO Y! N FEECURR[� Y!N <br /> Address Licensa p <br /> PLUMBER COMPANY <br /> SIGNATURE REG7STERED Y.! N r[C-CURRL� Y I N <br /> Address license i! <br /> MECHAN�CAL � CO�dPANY <br /> S�GNATURE REGISTERED Y 1 N FEE CURR[� Y/N <br /> Address License tJ <br /> OTHER COMPANY <br /> SIGNATURE Her,isrflaeo Y 1 N FcE CURRE� Y!N <br /> Address License r! <br /> � i � � � � � � i � � � � iii � i � i � � ie � � i � � i � i � i � � i � ii � iii � ii � � oi � i � � i � � � � i � ii � i � <br /> RESIDBNTIAL Attach.(2)Plot Plans:(2)sets of f3uilding PlOns;�1 y set of Enerc�y Forms;R-O-W Perrrdl for new cons�ruction, <br /> Minimum le�(7D)working days afler submiital data. Required onsi�e.Construction Plans,Stormaraler Plans w/S�II Fence inslalled. <br /> Sanitary Facililies 8�dumpster;Site Work Permit for subdlvisionsAarge projer,ts <br /> COMMERCIAL Atiach(2)complele sels of Buitding Plans plus a life Safery Pape;(1�set ot Energy Forms.R-O-W Pormil(or netH�conslruclion. <br /> 69inimum ien(90)working days afler suhmillal dale. Required onsile;Constructian'Plans,Srortnwa�er Plans w/'Silt Fence installed, <br /> Sanilary Facililies&t dumpster.Site Work Permit for all new projects.All'commorcial raquiremenls must meet compbance <br /> SIGN PERMIT AnaGi(2)sets of Engineored Plans. <br /> '•"PROPERTY SURVEY requlred for all NEW conslruclion. <br /> Oirections: <br /> Fill oul applicafion complet�ly. <br /> Owner 8 Conlractor sign back ol application,notarized <br /> If over 52500,a Notica of Commencement Is required. (NC upyrades over 57500) <br /> " Agen[(for Ihe contractor)or Potver of Atlomey(tor the ovmer)would be someone wilh notarized leller(rnm owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract requiredJ <br /> Reroots if shingles Sewers Service U�>yr�des AIC Fence:s(Plol/Swveyifootaye) <br /> Driveways•Noi over Counler i(on puhlir.ro:�dways..needs ROtN <br /> I <br />