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813-780-0020 City of Zephyrhilis Permit Applica#ion Fax 813-780-0021
<br /> � Building Department
<br /> Date Received rl phone=Contact for�Permltlln , - `-t �
<br /> Owner's Name - tfwner Phone Number '"1�
<br /> Owner's Address �`'� � � ti Tl�ner Phone Number �'� '.��
<br /> Fee Simple Tltlehotder Name � • � Owner Phone Number �� �
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<br /> Fee Simple Titleholder Addre�s
<br /> � � �� � � C�
<br /> dOB ADDRESS �� �� tJ� {~ i LOT#
<br /> suao�v�s�or► •�_G�?���,�lS � PARc���d# �o� - ��..a- � `t�' ��� � �
<br /> /�.��„� � C_C`J Ll�� (OB7NNED FROM PROPERTY7AX NOTICE)
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<br /> WORK PROPOSED - NEW CONSTtt� ADQlALT • �] SIGN 'Q [� DEMOL,1$H
<br /> ':e. INSTALL � . REPAIR
<br /> PRQPOSED�USE Q' SFR [� COMM' [_� OTHER '
<br /> TYPE OF CONSTRUC'TION Q ' BLOCK '' � FRAME C� STEEL Q
<br /> DESCRiPT10N OF WORK � l��.r
<br /> BUIl.DlNG 5lZE' Ct���lc�X_I� SQ FOOTAGE.CL.,�.�—LJ; - - FtE1GHT .�._�
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<br /> [�BUILDING �4 ���t��� ' �-� � �
<br /> `""�ulJ�-J
<br /> VA�.UATION:OF i'C?TAL CtONSTRUCTION
<br /> [�ELECTRICAL $ � � AMP SERVICE " �] PROGRESS ENERGY Q W.R.E.C.
<br /> [�]PLUMBING� $ p� � l���
<br /> ��� � �,/
<br /> . � f ,�-�J}��- �.�-
<br /> OMECHANiGAk. $ " VALUATIONOF'.MECHANICAf.INBTALLATION. "j�� fV�
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<br /> QGAS Q ROOFING .Q SPECIALTY �] OTHER �� �
<br /> Si
<br /> FlhitSHEQ FLOOR ELEVATIONS FLQOp ZONE AREA QYES N �J j("�
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<br /> BUILD�R COMPAPIY �fti� �j
<br /> SIGNATURE ~ � REGISTERED Y/ N FEE CURRE� ' Y/N"
<br /> /iddress � � � 1�� License•# `._:_.`� �(�c���� �.��
<br /> ELECTRICIAN Gf COMPANY ' ` �'�� O � � �
<br /> $IGNATURE 's REGISTERED Y/ N FEE'CURREK' ' "�Y/•N
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<br /> Adelra�ss �_�.�— _.___. _____.u� _ ... 1�fc,�ns�#-�----------- °.�- -
<br /> PLUMBEtt ` COMP.;ANY � `� � (� �
<br /> $IGNATURE� � . REGIS.TERED �./�N: . FEE CURRE� ' Y/N
<br /> Address � �� Ltcense# �•.�.,`� ,��1,�_�:
<br /> MECHANtCA1l` �z,��� COOAPANIf d �""�' ,.C'. ��i✓�v?/�4�' Y'
<br /> SIGNAT�JRE REGISTERED Y J N ;,FEE CuwtEn Y/N
<br /> Addres`s�= ' ' '' ' � License# �-'— —�
<br /> OTHER � , :; - ' ;COMPANY ` _ , � . ,
<br /> SIGNATURE "'� ` � ' ' ' � ` $ REGISTERED Y/ N . �FEE CURREh Y/N
<br /> Address . . . � - - Clcense# � 1
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<br /> RESiDENT1AL;�,� .AttacFi�i2);.PIo6P,lans;,(2)`sets:of�BuildPngiPians;(1)set af•Energy�Fairns;_R=0•-W'Perrrilt fc'r new constructian,
<br /> Minimum;ten=(1.0),wotking days;after;;submiftal:dafe.-Requtred onsite,:Gonstnic�orr Rians;Stormwater Plans wl S{It Fence instailed,
<br /> � �"Sant�eiy Facllltles:&;:1.,dumpste,r,,�Slte•Worlc�Permit,tor.subdiv,isto�s!large�pmjec�:s__; .:,�. `
<br /> I COMMERCIAL Attach(3)�ci�inpleYe�sets of Builidfes'g'Plan.;'plus a'Ufe Safety'Page;(1j se4 04`Energy Fonns.R-O-W Permit for new construcdon.� - --"-
<br /> ! Minimum ten(90}warktng days after submittal date. Required onsi#e,Construc#lon Plans,Stormwater Ptans w/Sllt Fence instalied,
<br /> Sanitary Fac11(Hes&1 dumpster.Sfte Work Permlt for ail neVu projects:.Aif commerclai requirements.must meei camplfance
<br /> SIGNPERMIT AttacFi"(2)sets�ofEnglneered-Plans..,�_ --�-� � �. � � �
<br /> '"*'PROPERfiY SURVEY r�quired far att_M1tEW canstructlon. ._ `
<br /> Dlrectlons: , .. •� � � „ '
<br /> Fili out apptica8an compteteiy.
<br /> Uwrter 8�Contractac slgn back af appllcatlon,aatarized �
<br /> I� If over S250q,a Notice of Gommencement!s requlred. (AIC upgradss over�T50Q) ,
<br /> '" Agent(for the contractor)or Powei of Attortiey(for�the bwner)woulii be someane with notarized letter from owner authoriz4ng same
<br /> OVER'TNE COUNTER PERMITTINQ:�w-•�{Eront�of Applica8on Only�• - �_.�- -<_ . _a�,_k. _ _ _
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<br /> Reroafs tf shingtes'�� SeweFs��' ��~�.5ervice Upgratles.A%C Fenaes(Plat/Survey/Footage) �,;;��, , ' ;. _
<br /> _" 1 r .._ .. .,z.��t��..� ..- ' ,��. , � vsi �.:,i�i�:.�-� i Yi�..,�.����i;l..:.i�,�. � ., �
<br /> Drivewaya-Notove`r,Counte�'tfon`publicroatlways::needsROW z; .,._, ..'4:1�,��..'r,°;;;;., V{� _1: �_�
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