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o��-�o�-���� City of Zephyrhiils Permit Application Fax813-T80-0021
<br /> Building Department
<br /> Date Recelved Phone Contact for Perm4ttin �� � ��� — �a�7
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<br /> Owner's Plame (� �Jd N��, Gwner Phone Number ���`r���"' �ocCJ. I
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<br /> Owner's Address ��� a� ���-�^ ��� 2. Owner Phone Number, � �
<br /> f�e Simpte'ritiehalder Name � � Owner Phone Number � � !
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<br /> Fee Stmpte Tltiehotder Address ',
<br /> JOB ADDFYESS .�I�� c�'�� ��• LOT# C�� ,
<br /> suso�v�s�o� �� � � pa�c���� ��1 0�� �-t L�G���9 l��QG� 1�0��
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PR4POSED , e �Ew coNsra�ADDlA�T � SiGN Q � DEMOLISH .
<br /> �NSTALL REPAiR
<br /> PROPOSED�USE Q SFR [] COMM Q OTNER
<br /> TYPE OF CONSTRUCTtON Q BLCICK ' [� FRAME �. STEEL Q
<br /> DESGRIP'�{ON OF WORFC �E '•�'�' � � � G��6A� E'�D7.Q.-� GF pT7'Y1 �NC.��S -�7 fv�, TOI�
<br /> BUtLD1TdG SlZE � � 3Q FOOTAGE HEtGFIT ���� !
<br /> QBUlLQlNG �� VAI.UATtt�N'OF 70TAL{�7NST`12UCT10IV ;
<br /> QELECTRIGAL ($ ^�_—� AMP SERViCE Q PRO�RESS ENERGY Q W.R.E.C.
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<br /> QPLUMBING �>� - �
<br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATlON. �
<br /> .�' �, ��
<br /> QGAS [� ROQFING Q SPECIALTY � OTHER
<br /> FI{VISHED FIOOFt ELEVATIOElS �� � FLOQD ZC1NE AREA QYES NO
<br /> BUlLDER GOMPANY �
<br /> S1Gt�lATl1T2E REGISTERED Y J R) FEE CURRER Y/N
<br /> Addrass L.icense# � � '
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<br /> ELECTRI�IAN COMPI0.NY �
<br /> StGNATIIR� � REGiSTERED Y! N FEE CuttRE� Y/N
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<br /> Addrass Llc�rsse# ( �
<br /> PLUMBER � � GOMPANY
<br /> SEGNATURE R��tStEREa Y t Pi FEE CURREP Y J N
<br /> Addre�s License# � �
<br /> t�ecH�wica.. � �j�`'� conn�,a�nr �+h�i��S r�o �}�/� L�5'�- e �'��
<br /> S1t31dATURE �� ��` ' i�~'1�.� REGI5TERED Y 1 N . �E cuRREt+ Y!tU
<br /> Addteas ��!'� � �l �'�J license# t��ITC�u �� I���
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<br /> OTHER ,COMPANY �
<br /> StGNATURE REG�ST�R� Y! N,. F�E GURREt� Y 1 N I
<br /> Address� Ucense# ,
<br /> RESIDENTIAL •Attach(2),Plot Plans;.(2)sets of�Building`Plans;(1)'set of-EnergysForins;R-0-W P.errrilt for new conshuction,
<br /> _ _ Mlnlmum�ten�{-1..0}wraricing;days<after,.sub�islttal date. F2eqitl�onsite,ConstrucEion Flans;8tormwater Plans w!Sllt Fence installed,
<br /> Sanitary Fadlides:&,1�.dumpste_r,-Slte`Work::P,ermit for subdivision§Aarge projects
<br /> COMMEFtCI�AI. Attach(3)complete sets of 9u11ding Plans plus a Ufe Safety Page;,(1)set of Energy Forms.R-O-W Permit for neW oonstruction.
<br /> Minimum#en{10)working days after submlttal date. Required ansite,Canstruction Plans,Stormwater Plans w!Silt Fence lnstallad,
<br /> Sanitary Fac111Hes&1 dumpster.Site Work Permft far all new�projects.All commerctal requlrements must.meet compllance
<br /> SIGN PERIIAIT Attach"(2)sets of Engineered�Plans.. -
<br /> '***PROPERTY SURVEY requlred fior all NEVI+cons#tuc�tEon. +
<br /> Dlrectlons: �
<br /> Fi4i au#applica�on completely.
<br /> Owner 8 Ca�tractar slgn back of applfcadon,notarized
<br /> If cver�28Q0.a Notics of Commencement Is required. (A!C upgrade�over ffi7500)
<br /> YR «Q ,� :"'...i{i,.:a-.�J.:.�
<br /> Agent(for the contractor}ar Power of Attomey{for the owner)would be someone with notarized letter from�owrier autliorizYng'saine --=° �
<br /> DVER THE COUNTER RERMITfI[dG� ' �(Fr"ont of Appllcation C�nly)��f . ,,� ,� .�-��� �. ,' -
<br /> Reroofs if shingles Sewers, Service Upgrades AtC' Fences(PtcsUSurveylFoatage} ; �- -�� . .�. �.� , , ``� .
<br /> Drlveways-Not over Counter If on putillc4►oadways..needs ROW� ; , " '-'' ' ,.�� ' ,_
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