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( <br /> � <br /> . st�7so=ooio City of Zephyrhi(fs Fermif Rppficafion Fax-813-780'-0021 <br /> Building Department <br /> Date Recefved 1 �C�1�� phone Contact for Permittin ��'�c � Z --� �D <br /> Owners Name �Qi'ZCL Owner Phone Number 0� ^ �� � <br /> Owners Address �O"� � ��. Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br />� JOBADDRESS 5�p �2��.� h �ht11S LOT# � <br /> -SU8D1V)SION �aRCE��n� �I-Z(s.-21-p�1�—p3 — b[c(� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPO5E0 � NEW CONSTR e ADD/ALT '� SIGN `Q � DEMOUSH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM � OTHER <br /> TYPE dF CQNSTRllCTfON Q BLOCK Q FRAIv1E Q STEEL Q <br /> DESCRIPTION OF WORK C.,7�( � e I J <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> BUII.DING $�(����� VALUATION OF TOTAL CONSTRUCTION <br /> .,�, <br /> QELECTRICAL $ AMP SERVECE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING � <br /> QMECHANICAL $ � VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS - FLOOD ZONE AREA QYES ,AtO <br /> BUILDER � COMPANY �� � � �� <br /> SIGPIATURE REGISTERED Y N FEECURRE� N <br /> Address p � 'L Q�� I� 1 h�� L� �I License# l� ��cJ <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N �cUwtEn Y/N <br /> AddreSs License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REOISTERED Y/ N FEE CURRE� Y(N <br /> Address License#1 <br /> OTHER COMPANY <br /> SIGNATURE �cis�o Y/.N �cuw�n Y/N <br /> Address License# <br /> � � � � � � � � o � � � � e � � � ti � � i � � � � � � a � oii � � � t � � � s � � � � � � � � � � � � � � � � � � � � � � � � � � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(t)set of Energy Forms;R-O-W Permit for new consWction, <br /> Minimum ten(10)working days after submittal date. Requfred onsite,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilitles 8 1 dumpster;Site Work Pertnit far subdivisionsllarge projects <br /> COMMERCIAL Attach(2)complete sets af Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-0-W Pertnit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanilary Facilities$1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPER7Y StlRVEY required for all NEW construclion. <br /> Dlrectlons:• <br /> Fill out'application completely. <br /> Owner&ConVector sign�back.af applicaFion,notar¢ed <br /> If over$2500,a Notice of Commencement is requlred. (AIC upgrades over$750D) <br /> " Agent(for the contractorj or Power of Attomey(for the ovmer)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy af contract required) <br /> Reroofs if shingles Sewers Servica Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs.ROW <br />