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s�sasaoo2o City of Zephyrhiils Permit Appiication Fax 813-780-0021
<br /> • Building Department ��.•
<br /> Date Raceiyed Phone Cantact for Permittin JP ��J –c��c/ �
<br /> 9
<br /> Owner's Name r't='� � � P t� �QD C/✓ Owner Phone Number J CC'I� �C� ���
<br /> �g ,.//� /J �-7 �7�J �.�`�'!aZ �
<br /> Owner'sAddress �d�75�O �7✓"� � �S /��- �� OwnerPhoneNumber �� �
<br /> Fee Simple�Titleholder Name � � Owner Phone Number �— �
<br /> Fee Simple?Titlehoider Address
<br /> JOB ADDRESS �� /`771• � h y' .�ll � �7a'Z LOT# C,�
<br /> SUBDIVIStON � � PARCEi;IQ#
<br /> (OBTAINED FROM PROPERTIf TAX NOTICE)
<br /> ` W4RK PROPQBED e . NEW CONSTR 8 ADDlA[.T � SIGN Q � Q DEMO�ISFI
<br /> INSTALL °REPAIR
<br /> - PROP.,OSED'USE Q SFR Q CQMM �] QTHER .
<br /> TYPE"OF CON$TRUCTION Q BI,OCK • [� FRAME � Sl'EEL Q
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<br /> '� DESCE2tPTiON OF WC}RK � � JG+-G�t � S �nI �t7/` d;�
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<br /> '"� Btl11:[}ING$t2� � � 5Q POOTAGE C,� HEtGHT �C . .,,..,,� �
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<br /> }UI�DtNG � �U�� VAlUAT1dN'OF TOTAL CONSTRCJCTION
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<br /> ,.' QELECTRlCAL � � AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
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<br /> � QPLUMSING $
<br /> MECHANICAL $ UALUATlQN pF MECHANkGAL.INSTALLATlON f�"�4`�
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<br /> ,QGAS Q ROQFING [�] SPEClALTY �] QTHER
<br /> FINISMED FLO�R ELEVATIQNS r`� FLOOD ZONE AREA [�YES NO
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<br /> -BUILDER £ � j �j; COMPANY �G2R/!��
<br /> SIGPIATURE e � �� REGISTERED Y N FEE CURRE� Y/N
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<br /> Address �License# � —�
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<br /> ,.:,ELEC,TRlC1AN ., COMAANY
<br /> ..:."SIGNA7URE REGISTERED Y/ N �FEE'CURRE� Y/N.
<br /> ".. Address � License# � ��
<br /> -,,:,�:.
<br /> ;' P.CUM�ER.,� , CONIPANY " -
<br /> �$1GNATUR� � REGISTERED Y-/ N FEE CURRE� � Y/N
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<br /> Address �License# � �
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<br /> .;:-MECNANtG14L' ' � COMPANY -
<br /> i�� SIGNATURE' �`� ' � " REGISTERED ,' Y/ N FEE CURRE� .. . Y�/N
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<br /> Addfe`ss-� - � � � -' License.# � .� ���
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<br /> �;,,QTHER" `.'-.. d; ' � COMPANY. .
<br /> f".'`.SIGNATURE:f� � - - . - REGISTERED Y/.N, FEE CUFtREK Y/N
<br /> � � Adc9ress,�. , , � � License# �f ��
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<br /> c..R�SfDE TIAL� ... .. . �.,. , . ,.. ,�y�,f:.;.• : �, ��,: .: . _ . .; , , • . .
<br /> Attac}�.(2}:PI'at:Pians•°'(2}:'°`s�of�Bufliiirig�i'lan"s;'{1•)`set'of`Energp�Forins� ��
<br /> , N___ .._ „ � � ° .� - set R'-OjW f'emiit-#or ctew,constivctian, "- ,
<br /> �`-,;� -;� ;�.�;>�r�-�: ;:Minimum;•ten,(;10).working�.tlays;afte�sutimittai:date.�Required�onsite;�Con`striictian Plan's,:Storinwater�Plans w/Spt Fence installed,
<br /> ;,��: �,.. :�.�,� , . .
<br /> f�•;:.__ '� Sanita;ry;Facilities��&�lydumpste.r,•;Site,.WoG1c Fermlfifoc'subdivisions/large°'projects�. � t'
<br /> � `_GONlMERCIAL At#ach�{2}�corripEete"sets of'BuiC�ing Plaos�plus a��ife Safety Page;{1}set of Energy Forms.R-O W Permit for new conshvcfion.
<br /> ; �;r " Minimum ten(10)working days after submlttal date. Required onsite,ConstrucBon Plans,Stormwater Plans w/Silt Fence installed,
<br /> '�-` - Sanftary FactliUes&1 dumpster.Site Work Permiffor�all,new projects.All commercia!requirements must meet complia»ce
<br /> 't�S1GN:PERMIT �Attacti(2}setsyof.,Eogineeiecl.`Plan,s:��: , , - ; � .
<br /> 1�""'�4 _ ""**PROPERTY SURVEY required for aII.,NEW constructlon: �
<br /> `�t:Dice�tEcans: s. . .:,. .. .
<br /> ' •Ffll,but�application completely.
<br /> �;;-„ O.wner 8 Gantractor sign back of appllcation,notarized
<br /> , tf over-$2500,s Notiee ofCommencemeat ts required. (AIC upgrades over$T500)
<br /> �.,:.. � ,:.5..< <>>r�,;
<br /> Agent(for`khe°confractorj or'�Power'of Attomey(fbr'tFie owner)wbuld tie someone with notarized letter from owner autharizing same
<br /> "�itEft:�THE�C{aUNTER PERII+t!?•,T.ING. .. (copy..of-confract required) - Y`' ``'
<br /> �ofs-if shingles 3ewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> 'reways�Not over Counter 3f orrpublic raadways..n"eeds ROW �
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