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s�3-�eaooaa City of Zephyrhiils Permit Application Fax 813-780•oa2� �
<br /> _ • Buitding Qepa�trnant . �'4�
<br /> Date Racetved _ -, PhonexGqntac@far�Penn[ttin . I
<br /> Owner's Name ��"1 M""� Owner Phone Number � .� ' ,
<br /> Owner"s Addres� -� - c,,,_ Owner Phone Number � *�
<br /> Fee 8lmple�Tltleholder Name l � � Owner Phane Numbe� �! �
<br /> Fee Simple'Tltleholder Address -
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<br /> JOB ADDitESS �'��l G� � �"+� ►"h� `�'� � L'OT# ��.
<br /> SUBDMSiON � � P,ARCEL ID# - � '
<br /> i , ., (08.TAINED F.ROM,PROPER7YTAX NOTICE)
<br /> WOttK PRO,POSED �.NEW CONSTR� . ADD/AI:T �� S1GN" [J � � �C] DEMOI:tSH
<br /> � e. INSTAI:L 8 REPAIR
<br /> PRQPOSED.U$E � . Q $FR [� �CQfU1M� [� �QTHER „
<br /> TYPE OF CqN3TRUCTION' Of ` BLOCK " Q FRAME ,� �[.',_] �STEEL Q
<br /> DESG131PT10N OF WORK'
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<br /> BUI�DiTt�a'�IZE '� � BQ�FOOTAGE��� � ,,HEtGHT ,�_� � �
<br /> �s�`���fi' � ) S",(r- ���� VALUATION:G'1F='fOTALCONS'TRUC7iON,2 z `
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<br /> QEl.EGTRIGAL ' r$�' �- AMP SERViCE Q PRfJGRESS ENERGY Q W:R.E.C.
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<br /> QPLUMB[NG- -���-�� f�l `�'�
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<br /> QMECHf1NtGf1L $ ' ifALUATiON O�iMECNANICAL INS1`AlLAT10N .
<br /> QGAS i Q ROOFlNCa �Q SPEGIAI.`FY;,� QTHEft ; .
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE A.REA QYES ,„NO
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<br /> 8U F.DER ��;
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<br /> COMPAt+lY� .
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<br /> SIGNN►TURE `� REGISTERED Y/ iV FEE CURRE� ' Y/N °
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<br /> � Address � f' , . `t-� . .Gcense#'( � ' � � �
<br /> EI.EC1'FtIC1AN: _ � � � , �,,OM�� .
<br /> ', SIGNATURE � REGIS7ERED Y/ N FEE CURRE�^' � `=�Y/N
<br /> �►ddres� ` " .._ � _ License#�,� �
<br /> P�UMBER '� ,GOMP�WY "` . , •
<br /> SIGNATURE' � ,. REGIST,ERED � _ Y,/,.N;3 ,,FEE-CURRE� Y,/N.
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<br /> Addre�s , Lice►ise,# _ - - �s.
<br /> MEC�iA�11CA1: ' '. . , • . COMPANY � _ � . .
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<br /> SIGNAYURE � � ' `L REGISTERED Y../ N ;� FEE'CURRE��� Y./�N. • -
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<br /> Addre�s� ' . . ,. . ` `` � �. _ ' � License#�� i
<br /> 07HER r. . , `. �_ , +`�GOMPlI�tY` _ � , ' � „
<br /> SIGNA7UFtE =r�� ;% ' . . " `REGISTERED"" � 'Y/ N...,=: FEE CURRE� Y/N
<br /> Address. .. ., , _ t�. - � ..r;� , . Llcense#'� � . , � '� '
<br /> ttESlOEN'{'IAI:„;�_�;Aitaicti�'(2):Rto�Plans;.tf2}sets:of:Butldl`ng�PEaiis;'(1)setof'Energjr^For`ms;��R-O=W�Pericilt#ornewconstruGfidn,, ' ' " , �
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<br /> �r •:>>�Mintmum,tlen9(:1,0)kwqrkfng;days_afte��subm�tEal`d'ake.�:Requlred onsife,�Con`etiiicNon`Rians;�Stormwater Plans w/SilEFence installed,-
<br /> � `.`�..:SanitaryFac4lides;&rlo;dw�npster�*SIte,41tor4c,Pertnitfor'subtli,v.islonsAargerprojeots°�..:�,�';._:., _: -� -
<br /> GOl111M�RCIA1: Attach.{3}�complete sets o#Bullding Plans plas a I.ife Safety Page;(1j set of Enercjy Fomts:R-O-W Petmit�far nevu�constructlan. °
<br /> Mintmum ten(10)working days�after submlttal date. Requlred onsite,Canstruc#lan Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles 81 dumpster.Site Work Permit for all newfproJe6ts:.All commercial requlrements_mu&t meet compliance �
<br /> .St�N PER�MIFT Attadi{2)se�of'E'rsglneered;Plans.;' . .. �, �� -._ � . . .
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<br /> ••"". .--�-- • reguired for aq„NEW aanstructlon.�,
<br /> PROPERTY SURVEY._ ..
<br /> Dlreetlons: _,....:_�'.,.. w . � ,
<br /> Fill out applicatlon completely.
<br /> Qwner&ContracMr sign back of applica8on,notarized
<br /> if over 32500.a Notice of Commencsment i�cequirad. {AtC upgrades over 57500) , j
<br /> M ,:.�eyt'ti�:�..Y,,,7.
<br /> Agent(for the cantractor)'or`Pow��of Atfnmey(fair tFie�ownerj would�be someone viiith notarized letter 1'rom owner auUrorizing same
<br /> OVER TtiE COUi+1'fER.PERMI?fTiNG_._...._.,(Frant of�AppllcatIomOnly}�_ - = , _ . , �
<br /> Reroais if shingles Sewers Service Upgrades A/G Fences(PIoUSurvey/Foatage) �
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<br /> Drivewaya-Not over C.ounter if on'pub'�i`c r"oadway"3:.ne�s'Rf3W`'^'�� K .r.�._ _. .. ._....-
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