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o�yfo�-uU�U City of Zephyrhiils Permit Appiication Fax-813-780-8d21 ,
<br /> . � `^ , � Butlding Departrnent -
<br /> Qate Rgcsived phone Contact for Permlttin J ��� - ���
<br /> Owner's Name V���. Ownsr Phorta Numbar �cc��"' ���" �j�c
<br /> Owner's Address '��l`� ��'��� ��'a /NA'�� � Owner Phone Nurrtber � �
<br /> Fee Simple Titleholder Name � � Owner Phana Finmber � �
<br /> Fee Slmpla 7ltleholder Address
<br /> J08ADdRESS ����� �'I"���11 � L�-� I.OT# ���1
<br /> SUBDIVIStON 1f L�t����� � PAt2CEL ID# �U✓ O"'l� ���GS �� ��!"
<br /> —l�— (OBTAIN�D FROM PROPERTY TAX NOTlCE)
<br /> WORK PROPOSEQ , e NEW CONSTR� ADD/ALT C� SIGN 0 [� DEMOLISH
<br /> INSTALI. REF'AIR
<br /> PROPOSED-USE [� SFR [,�] COMM � OTHER
<br /> TYPE QF CQNSTRUCTlQN [� BLOCK ' [� FRAME [� STEE� Q
<br /> UESCRIpTION QF WORK /�G�S �' Cj C11�'N G��D-w- j � O �a1J � T!�`�f
<br /> BUf�DfNG SlZE ��� 5Q FOOTAGE�� HEIGHT ��
<br /> QBUILDING �� VAL,UATIOIN OF i'C11'AL CQNSTRt.1GT�ON
<br /> [�ELEC7RICAL �� AMP SERVlGE Q PROGRESS ENERGY Q W.R.E.C.
<br /> [�PLUMBING �� �
<br /> MECHANtCAI. $ '� VALUATION OF MECHAN�CAL INSTALLATION.
<br /> ��R5 �.
<br /> �]GAS [� ROOFING .Q SPECtALTY � OTHER
<br /> FINlSHED FLOQR ELEVAT{ONS ��� FLOOD ZONE AREA [�YES NtJ
<br /> BUILDER COMPANY
<br /> SIGNATURE REGiST'ERED Y t PI FEE GURREA Y!i�!
<br /> Address Llcense# �` I
<br /> ELECTRICiAN GQMPANY
<br /> SIGNATURE � REGlSTERED Y t N FEE Ct1RREh Y/Z3
<br /> pddrp� tfcense# � I
<br /> � PWMBER " � � COMPANY
<br /> i SIGNATURE � REGl�TERED Y/ N FEE GURREA � Y!N
<br /> I (�� �]
<br /> I Address i,tcense# [ t
<br /> MECHANtGAC ��.�7'��z'\ ��,Y�fA�,'rt.�h-"' COMPANY '��I�FR�S cs�o-,9'/1��. ,L,^Pqg•¢"�"f�.�.L/1�G.,,
<br /> SttiA1ATURE � REGISTERED Y/ N . FEE CURREt+ Y/�N
<br /> Address "<._.� � f/ �� l.icanse# I�"�? ���7-O � �I
<br /> i
<br /> pT}{�R ,COMPANY I
<br /> SfiCNATURE REGISTERED Y/ N-. FEE CURRE� Y/N
<br /> Address Ltcense# �i �
<br /> I
<br /> � RESlDENTIAi: Athach(2).FIot.Plans;(2}se#s.of�E3uii8i`ng`Pfans;(1)sat af-Etiergy}Foims;R-O-1N Permi#for new cans.truction,
<br /> Minimum:ten;(10):wocking days:after submitfial date, Required onsite,Cons`tructiomPians;Stormwater plans w/S�It Fence instat�ed,
<br /> �; Sanitary FacRities:&-'I:,dumpster�Site Work,Permit for subdivislohsflarge projects �
<br /> I, COMMERCIAL Attach(3)complete sats of Building Plans ptus a Life Safety Rage;(1)set af Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(18}working days after submittal date. Required onslte,Construction Plans,Stormwater Plans wJ Silt Fence installed,
<br /> Sanitary Pacilities&1 dumpster.Site Wark Permit for ai�new�projects.All commerclal requlrements must meet campliance
<br /> SIGN PERMi7 Ai.tach"(2)sets of Engineered�:Ptans. -
<br /> •*•'PROPERTY SURVEY requlred for a1t NEW construction. • � �
<br /> Dlrections:
<br /> � Ffll out applicadon completely.
<br /> ', Owner 8 Cantractor slgn back of applfcatlon,natarized
<br /> If over a2500,a Notice of Commencement ts required. {AIG upgradss aver$75Q0�
<br /> � " Agent(tor ttte cantractor)or"Pawer of Attomey(for the owner)wouid be someone with na#arized letter from awner authorizing same
<br /> ..:...�.,�.f
<br /> � OVER tHE COUN7ER PERAAITTING_„ :. (F.ront of.Applicattot�Onlyy� . � { . ,� , ,i .
<br /> Reroots if shingles Sewer's Secvice Upgrades A/C. ' Fepces{PlaUSurveylFootage) � �. . . . .
<br /> , - , - , .�� .. ., _ -�
<br /> Drivewaya-Not over Counter if.on public roadways..needs R�W', � '� . , `
<br /> ��� .. ' .. �� . .. � � .� . �. n . � ^6-' ._. .
<br /> � , ,. - , .. ',. : `, ,. ,. u .ro.,.,:�..:�" �';
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