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813-780-0020 City af Zephyrhilis Permit Application Fax-B13aso-aaz�
<br /> Building Qepartment . .
<br /> Date R�eeiyed ` �• �"� •�/`� , �;: Phone=Gantact far P�rrtiit#In :,
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<br />'I Owner's Name Ol'� � Owner Phane Number ��� ��G '
<br />' Owner's Address � �� Owner Phone Number
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<br /> Fee 5lmple Tltleholder.Name �- Owner Phane Number
<br /> Fee Simple Titleholder Address
<br /> J08 ADDRESS ,l // ~ �/ �� LOT# C�
<br /> SUBDIVlSIOF1 '� , --� ` PAitCEL ID# � � 7 L�6 �(,� � ��`-'
<br /> , - �• , . , (OBTAINBD FROM PROPERTYTAX NOTICE)
<br /> WORK PROP0.SED �NEW CON5TR ADDlAtT � StGN �Q- � DEMOt,IS1-t
<br /> ���e, �INSTALL 8 ',:REPAIR �l U`'1 .
<br /> PRQPC?SED�USE - �- Q 3FR. �� GQMM � �OTHER • r r" 2 �
<br /> TYPE OF CONSTRUCYION � Q�•' '' Bl»OCK " Q FRAl1AE � 'STEEL Q
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<br />� DESGRIRTION OF WORK !^�'
<br /> BU1LDtNG SIZ�`'�� �'SQ FOO'TAGE�_�_ : _ MHEtGHfi�:��
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<br /> �St!lLDING �� �- ' .�-, < -
<br /> . f VA4.t1AT10NaCSF`TOTAL'CONSTRUCTION � v
<br /> EI.ECTRIGA� $ � AMP SEF2VICE Q Pt2t:1Gt4ESS ENEFtGY Q W,R.E.C.
<br /> � . ��____�!�� , . .
<br /> QPLUMSING V� � ` . ��� _
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<br /> [,�MECHAN1GAl $ � VALUATiON pF:MECl1ANlCAR.II�ISTALIATlON!
<br /> QGAS Q ROOFtNG Q SPECIAtJJY C] OTHER
<br /> � FINISHED FLOOR ELEVATIqNS �� FLOOD 2QNE AREA [�YES ,NO ,
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<br /> � � _---=__ -�..,_�___ �-�.-- -_____-____
<br /> BUf�DER____ __ __._ ________ _..__ _ - _--___-�OMPA[+iY`~ " -`—� `--- � --
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<br /> i�- SIGNATURE REGISTERED Y/ N . FEE CURREP Y/N'_ .
<br /> �ddress � � � [:icense# � �
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<br /> EC�CTRtCIJIfil;•. - - �COMPANY `
<br /> SIGNATURE� '� REGISTERED N FEE CURRE�*� � � /N
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<br /> Address � �, � � � , � . ... License=#:'��-;j���a �-�",,��
<br /> PLUMBER..� COMPANY , . ...,;:t =
<br /> SIGNATURE` ` REGIS7ERED,. - Y/,.N.�. ,,FEE CURREP_ Y�/N� , '
<br /> Address . . _ �,.Ltcerise�# �, :. .. .,�� �
<br /> MEC1fANICAF:`� - ,. � ' � . Cfl�tf�ANY '.� � ,
<br /> � $IGNATURE� • ' °' " ' �` ' �� ' REGISTERED_, Y./ N ;� PE.E�CURF3Et��_ Y/�N ,
<br /> � Add�i •.�_ ��.� .�� � � � _ � . � , �Icense#�� .�• ,, t -
<br /> �'� tYf#{Hi2 = r '.' w , : -n �, ,. � . .� , :CQI�PANY� � , ,� �
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<br /> � SIGNATURE -- `'� • ' - REGIS7ERED� ' , Y/ N_.r �;FEE CURRE� Y/N.
<br /> Addreas, _ �� .�.. ` - . = F ' ' , Llcerise# �— . � ' ' . ��
<br /> _�t;.. .,.y.�..�: " F:. +7- . ,_ `.�� t,�y:,.• .,q: ;,- , . . �3' .
<br /> ` ' . ,r-. :r�. -.., � .... „ �.._...<, .
<br /> RE3lDEPIT�,Ai;,;;.� ,4#tacti"(2):,PtofiP.lans;,,(2�}'s'els=of:Buili2ingfPtan`s,�{1}setof=Eneigy',Fartns;rR=O=W�Perinitfornew;constructian, ` �
<br /> ��Minimum,ten;(�1.0)�viroriiing"de" �f.`
<br /> -�:f�,�,s�:.,:..��.�., . ,.,! ..�r� . ,n ,ys<afte.r`,�sutsmlttal'date:w:Requl�ed onslte;:ConstrucBon=Pians;�$tortnwater Pla�ns w/Slit°Fence lnstal�ed,.
<br /> � �Sanifery'Faciliyes&1,e,du,m,pste,r,xSite•Worlr�P:,ermitforsu6divisions�aige:proJeats=,.,.�.'-.;�;:. . , �_ , ' . -'-
<br /> COMMERCtAl. Aftach{3)`c6mplete sefs`of 8uit�iiig'Pians plus a`Cife�Safety Page:�{1)set of Energy Fctins.R-0 W Permit far new canstructEon,
<br /> Minimum ten(10)worlcing days�after submittal date. Required onsite,ConstrucUan Plans,Stormwater Plans w/&Ilt Fence installsd,
<br /> Sanitary FaoiliBes&1 dumpster.5ite Work Permit for all new:prqjebt'saAil commercial requlrements.must meet compllance ' '
<br /> SIGNPERl4}IT Attacti`{2)sets�ofEngin.eered=F?lans:,; � ,. �. -. .. ` , � �
<br /> ;.. ti.r .. ,
<br /> '•*"PROPERTY SURVEY required for atl„IVEW_,canstructibn., . _ _ � , _
<br /> ,.,.__ ._.�_..._._.,_..__.,......w....K _ - -
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<br /> .i}!r`8"Gt10t18: ��r�v-.'�,; ... . . , .. � ` ,
<br /> � Fill out applicatlon completely.
<br /> Owner&Conhactor slgn back of appl[caUon,notadzed �
<br /> If avar�2500.a Notice,of Cammencement t�r+�quirad. (AtC upgrades over 57500}
<br /> ;.;__:����,�,>,;,�;;,,. .
<br /> .. _ �w.,. _.
<br /> Agent(for Uie contractor)or'Power of Attoimey(fo�tlie owner)wbuld be someone with notarized letter from owner authorizing same
<br /> t}VER"THE Ct�Ui�t7ER,.P,ERMITGlNG.._ ._;...{Front af ApplicattomOniY)... ._ , ,
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> �riveways-Not over Caunter if an public roadwiays..iieed`s ROW
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