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s�s-780-0020 � Cify af Z�phyrhilis Permit Application Fax-813-780-0021
<br /> - � Building Repartment
<br /> D�t�Rec�ived ¢ Ut � �(,�t� ' @�hone`ConQ�c�fcir P�emiQtin C.}t� � �� �{.F��.
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<br /> Owner's tVaenm ��� �a ' � Own�er H�hone Plucvtber �� -3�a —��W I
<br /> Owne�'s:Addr�ss. I Owner Phone�9�amb�r �� �
<br /> F�e Simple Titleholtler�i�am� �� � �wner PY�a�a�e�9urmfoeP �— �
<br /> Fee Siunple Yitleholder�,dd¢e�ss
<br /> �o��;�n�a�ss �?���J � �� �1 (�1 i� S � � � � ��o� Lor� � ��
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<br /> (pBTAIPJED FROIIfl PROPERN TAX PdOTICE)
<br /> �I�RK�?�OP�O��� � N�w coN5zR ADDlACT � SIGN C] 0 DEMOLisH
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<br /> � INSTALL 8 •REPAIR
<br /> ��OP,,O�ED USE � Q 5FR Q COMIVI � QTHEFt —v
<br /> YYP�CiF COP�STI3UG'TIOPJ j Q BLOCK • Q FRAME � STEEL. Q �
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<br /> �Esc�ai��na�oF.wa�xa� � �:`o�F ,�P ..�c3tr� p��{ � �t�� 1 +�I e,S c.�Ji�-�'1 G S� t'�I�.rr- �C U�} C�¢.�l'i�
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<br /> �v��:�t����z� � � ,. � sQ�oo��;�� .c���b ¢a�i�w� ��_� � i�ve'Y1CLt'�
<br /> �BUl�DlN �' $ (����J t�!? � VALURi'I��OF TOTAL CONSTRUCTiOht
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<br /> [�ELECTRICA� � $ AMP SERVlCE 0 PRC}GF2ESS El�EF2GY Q W.R.E.C.
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<br /> QPLUMBING � � �
<br /> [�MECHANtQAL ' �; � VALUAT[QiV OF IUIECliAV�ECAL INSTALLATE01� �,�
<br /> [�GAS Q ROQFIRtG Q SPECIALTY � Oi'HER �
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<br /> FIfVISHED FLQOR ELEVATIdiVS r�� FLOOD ZOiUE AREA �YEB fV0
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<br /> �uiL�E� c����av
<br /> �����+���� REGISTERED Y/ (V FEE CURRE� Y/IV '
<br /> ,�cPc9r�ss -License# �— �
<br /> �I.�CY@�I.C1RR1 C�fl!➢O�FrIUY
<br /> SIGf��,TURE REGISTERED Y/ RI FEE CURRE� Y/N'
<br /> dlcPc�ress ticense# �- � �
<br /> �i.u����. �o�t�,�v-
<br /> 'SIGWAATURE REGISTERED Y�/�N- � FEE CURRE� Y/N
<br /> +QddP�ss License# � �
<br /> �il��F�i4�tCAi: � C��11@��Y ' .
<br /> SBGV�A4TlDPdE• � REGISTERED Y/ fV FEE CURRE� Y/•IV'
<br /> ,4t9�r�"ss Lic.ense.# �— �
<br /> c�����a- .. , �� co�p�v tt}`�C� (�t;�t� �G'�C- ,
<br /> SIGMA'B�URE:� �; ,REGISTERED Y/ N FEE CURR ' /N
<br /> At�c9P�ss. �,! `[� r !�.. 't �� I�S �� License# CCr��..l���S�� �
<br /> Q2E�ILlEt�TtAR.;�. Attach�.(Z)sP2df'Pians;'�`(2)=sefs�ofButlii9rig�`Plan§,.{9)'se�'of'Energy`'Fafi7is;'R-O,UV:Permit.fornew.consfructipn,.
<br /> � :, • , �.MinimUm:,:ten?(,1'Q)wprklhy;tlay",s�after-submittal�d�te. 'Required�on�ite�'CanstrocGon Plans,.S�tormwater Plans w/5ilt Fence.installed,
<br /> �3 Sanitary;Facilities�,&};�1�.:dumpster S,.,ite: ,W.or;k�Rermitfor;'sutidi"vis'ions/large.projects
<br /> �OiU3M�gtG0,4B. Attaoti(2}ebriYple#e"sets of Buitd�rig P1ans plus a Llfe Safety Page;{1}set af Energy Forrrss.R O-W Permit far new construction. ,
<br /> Minimum ten(10)warlcing days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/8ilt Fence�installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit fo�all,new proJeats.All commercial requirementsmust meet oampliance
<br /> �SlG�i P'E�1�li' A#fach{2}sets ofFErigineererl Plans:���
<br /> *""*PROFEF2TY Sl:1RVEY required for.all.NEW.construction.
<br /> Dti�cY9ons: _ _ ,_ -
<br /> Ffll out appiieation aompletely.
<br /> Owner�Cantractor sign.back of application,nota�ized
<br /> if over$aS00,��IO$�C�O��GOlYIIYl�PfC�(i'l�91Q IS P¢.'t�II1iP�t0. (,�1G u�gr��+es ov�p$7�Od)
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<br /> '" Agent(for'4he cont�actor)•or Power of'At4oFney(f6r'the ovirner)would tie�someone with notarized letter fram owner authorizing same
<br /> .E?UER.Ti��'GC1i3,�tI3ER;�?ER�U(}�"�'I�G {copy of confracf�required} �
<br /> Reroofs if shingles Sewers� 8ervice Upgrades A/C Fenaes(PIoUSurvey/Footage) , _ •
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<br /> �r�vevuays»tltcttaves-Gauntec:iF_ort pu6lia�roadvuays:xneeds R4W : _..__. _ .�. ._ - µ._1-� ..
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