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a�saeaoozo City of Zephyrhilis Permit Application Fax-813-780-0021
<br /> • ' Building Department �
<br /> Date Received /�' Z'7— �7 phone,Contact�for:Perm(ttin �.-�Z-1 .3)o _ �'�9 �
<br /> Owner's Name �«f�' I�Qd��(Z (Yl(yT• („(.C_. Owner Phone Number
<br /> owner•sAddress �Ky7 ,�Ut��-Pt('� S"�a'n(]r� ,��2 ,��a.crl.. �
<br /> "1' Owner Phone Number�
<br /> Fee Simple,Tltleholder Name ' Owner Phone Number -
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<br /> Fee Simple�Tltleholder Address "
<br /> JOBADDRESS S(2D SIZ.Z 5�2�( (r� ST. LOT# �
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<br /> SUBDIVISION PARCEL ID# �����i-Z� '00�C�" (�S�O�OZI(�
<br /> j , . (OBTAINED F.ROM,PROPERT1f TAX NOTICE)
<br /> WORK PROPOSED NEW:CONS7R ADD/ALT Q SIGN Q Q DEMOLISH
<br /> a _ �B. INSTALL 8 REPAIR
<br /> PROPOSED=USE Q SFR Q COMM Q -OTHER � �
<br /> TYPE OF CONSTRUCTION Q BLOCK " Q FRAME �Q .STEEC Q
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<br /> DESCRIPTIONOFWORK� Z�l'roU� �A�O LAG�. E,�ISTl(`��s F}$Q�4(�T S}�I�C7t�S df', S� -
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<br /> BUILDING SIZE - � SQ FOOTAGE ��IS�� . ,HEI,GHT�. �.`S� ,r
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<br /> QBUILDING $ do � � - � - � •
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<br /> �,�• �' VALUATION:.OF�TOTAL'CONSTRUCTION
<br /> QEIECTRICAL $ " AMP SERVICE Q PROGRESS ENERGY Q W.R.E:C.
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<br /> QPLUMBING '$ -
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<br /> QMECHANICAL $ � � VALUATION OF,MECHANICAL INSTALLATION � �� �q
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<br /> QGi4S Q ROOFING .Q SPECIALTY Q OTHER
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<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. ,NO
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<br /> BUILDER , ` COMPANY=�• � m�l�('�1s '�UIVO�(ZS I1�(L .
<br /> SIGNATURE REGISTERED Y/ N �E CURREn 'Y/N
<br /> Address a � S�. {6S�Go S�r P.p S�nun��ir,,,ow' �I Cicense# CGC �3 �t '
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<br /> ELECTRICI,AN- - �COAflPANY
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� ' "" "'Y/N
<br /> Addres`s ` :�� License# �
<br /> PLUMBER j - COMPANY �; ; ' � . ,
<br /> SIGNATURE ' ; . ReG�S.7ERED, > Y-./..N,� �;;'-rFEE CURRE� " Y/N -:
<br /> Address " � , � , . , . . :.License,#� - . � -
<br /> 3 .
<br /> MECHANICAL' . . . - COMPAM! . ' _ l -„ - " .
<br /> SIGNATURE } " �. REGIS7ERED, � Y�/ N. _FEECURREA=; X.,/N
<br /> Address'� , � , , � . � - , - , . . . � ,. License�# .
<br /> OTHER 'i r" � . . . . , = ��COIIAPANY" . - � ---
<br /> SIGNATURE `•. - '- ' ' " � ' ` � �° `REGISTERED ' ' ' Y/ N�. � FEE�CURRE� Y/N
<br /> Address ' - . , _� - "L'icense# , . '
<br /> � �., - n , .-�.����.�;'; .,, y.:m;., �" :` " :.�� . f' .� ' �'i' . - ,. . � .
<br /> RESIDENTIAL,i, •Athach"(2),PIot�Pians;:.(2)§ets.of=Building�Rlans;�(1)setof-Energy�Fo'rins;.R-0=W°Perrriit for-new construcUon,
<br /> ,. :.�-Minimum:ten;(;1.0)�worliing,days;after„submittal date.;Required dnsite,�Con§triicdon=Rlans;Stomiwater Plans w7 Sflt'Fence installed, '
<br /> 1 1 -Sanitary`Facil(tles_&;;1;dumpste_r,-Sfte�Worlc;;.P..ertnitforsubdidisions/large�projeots.;_,,. -� " �� �r � "� �
<br /> COMMERCIAL Attach(3)�complete's'e4`s'ofBullding"Plans plus a`Life`SafeEy Pege;�(1)sef of Energyi Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days'after submittal date. Requtred onsite,ConsUucUon Plans,.Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides 8 1 dumpster.Site Work Permit for all new projects.,All commerGal requirements_must meet compllance �
<br /> SIGN PERMIT Attadti(2)sets of"Enginee[ed-Pl�ris:;.��.�:,-° .� ,. •
<br /> "'•PROPERTY SURVEY reyuired.for all NEW aonstructlon..
<br /> Directions: � .. - � _ ' '
<br /> Ffll out applicaUon completely. ,
<br /> Owner 8 Contractar sign back of applicaUon,notarized
<br /> If over a2500,a.Notice of Commencement is required. (AIC upgrades over aT500)
<br /> �:� .,,;,,,�.
<br /> '" Agent(for the cantraotor)�or'PouVer of Attomey(for tFie owner)would be someone with notarized letter from owner autho�izing same
<br /> DVER THE COUNTER PERMITTING� .�-: (Front of•Applicatlon Only)- "
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drivewaya-Not over Counter if on public roadways..need's ROW
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