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���-,o�-���=� City of Zephyrhi!!s Permit Application Fax-813-�saooz� <br /> ' � ' Building bepartment - <br /> Date Raceived Phone CanWct for Permlltln �`� ���-- ���� <br /> /� �(/ ~ `'� Q Sff�"' t��a�' 10� <br /> Owner's Name �� ' v[✓d L j �'`✓��� Owner Phone Number <br /> Owner's Address .:1/1� �� �� Owner Phone Number �� M1 � <br /> Fee Slmple Titleholder Name � �' Owner Phone Number � � <br /> Fee Simple Titleholder Address <br /> JOB ADbRESS �l� �� � ��«'S¢ ��� L.OT# � <br /> suaoiv�s�o� � � PARCEL ID# � � —��.' �1"l.�P>�1.� � �D� �`� <br /> {OHTAINED FROM PRQPERTY TAX NdTiCE) <br /> WORK PROpOSED NEw CONSTR ADQlALT � SIGN Q Q QEMOItSH <br /> � e INSTAL.L REPAIR <br /> PROPOSED�USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCT10N Q BLOCK " Q FRAME C] STEEL Q <br /> DESCRIPTit3N OF WBRK �r �� � �0" � �D?t� � /-i L �rl�77�7 11�/1l <br /> BU!!.DlNG SlZE � _� SQ FOOTAGE NElGNT ��� <br /> QBUILDING $ —'---—� VAI.UAT10idFOF`�i'O'fAl.CONSTRt►CTION <br /> [�ELECTRICAL ($ -� AMP SERVICE [� PROGRESS ENERGY [� W.R.E,C. <br /> ��_ <br /> [�PLUMBING ($� � <br /> �.— <br /> QMECHANICAI $ �q���� VALUATION OF MECHANICAL INSTA4LATION <br /> r <br /> QGAS Q ROOFING [� SPECtALTY Q OTHER <br /> FiNISHEd FLOOR ELEVATIONS C�� FLOOD ZONE AREA QYES NQ <br /> BUILDER COMPANY <br /> SIGNATURE REGfSTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> ELECTRICIAN COMPANY <br /> StGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Llcense# ( � <br /> PWMBER � COMPANY <br /> SIGNATURE � REGISTERBD Y/ (V FEE GURRE� Y/N <br /> Address Llcense# � ���� <br /> MECHANiGAL �� �`�"� ` • COMPANY �r��6 /�i Y9-Jll��-�-���jq�$91--•yG°---=TiIIG: <br /> SEGNATURE L�^�/J'�� REGtSTERED Y J N FEECURRER Y J N <br /> Address ��l �"� � � License# (�°"�r`'�-� ���7 6 �� <br /> O'fNER ,Ct.�MPANY <br /> SIGNATURE ,_,__,,_,, tt�GistEREo Y I N . FEE CURR6R Y!i+t <br /> Address Ucense# �_, � <br /> RESlDEN1'IAL' �Attach(2}.Ftof Plans;(2)sets of�Buitd(ng"Pians;{1}set of-Energy�Forms;R-q-W PermiE far new aonstruction, <br /> MlNmum_ten�(-1Q}working$tlays after,:sabmtftal date. Requireil onsite,Constiucflon Pians;Stormwater Pians w!Stit Fence insta4led, <br /> Santtary EalciifUes:&.1:.dumpster,-3tte WorkPermiffior subdivisionsflarge�proJects <br /> COMMERCiAt„ Attach(3)aomplete sets`of Bu{tding Plans{itas a Life$afeiy Page;(1)set of Energy Forms.R-O-W Permlt far new«ansUvcUon. <br /> MEnimum ten{1Q)workfng day5 after submftta4 date. Reqaired onslte,ConstrucHon Pians,8tormwatsr Plans w!Si(t Fence instalied, <br /> Sanitary Facili8es&1 dumpster.Site Work Pennit for all new�proJects;AU t�mmerclal requlrernents must meet compltance <br /> SiGN PERMtT Attach"(2}sets of EngineeredcPlans: <br /> ""PROPERTY SUR1tEY required far ali NEW constructlon. <br /> D)rectians: <br /> FtN aut applica�on ccmptetely. <br /> Owner 8 Contractor sign back af appttcadon,notarized <br /> If over 52500,a Notice of Commencement Is requlred. (A!C upgrades over:6T5Q0) <br /> `• Agent(for#he contractor)or Power..o,f�Attomey.(fQK the�o�ner)would b�e s�omeone with notarized lette�from,.awner.authodiing,same;,_„;.. , ; <br /> .. f � - <br /> OVER THE COUNTER PERMITTING � (Front of Appllca8on QNy) ' : -. ' � ° <br /> Reroafs if shingies Sewers Service Upg'radas A�C' Fences(PIatJSurvaylFootage} _ � ' <br /> Drivewaytt-Not over Counter if an public roadways..needs'ROW -- ' <br /> , ... ` .. -,..--:,.� -. ..,. _-,,. , �. ,. ,- ..a _.. , . , , . . . , .. <br /> � <br /> . f <br /> `�,,� <br />