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8'13-780-0020 City of Zephyrl�ills Permit Application Fax-813-780-0021
<br /> ' Building Department
<br /> Date Rgceived•� � �
<br /> Tl-fT�-[�-
<br /> Phone Contact for Permitting `"��"��r`�'��'�`o��`c`� �' � � �'��•�'���
<br /> r
<br /> Owner's Name � � � ,� _ � � •� �
<br /> Owner Phone Numher l �� ,�L�L�'. � ��
<br /> Owner's Address ���Q���I� �ra ,�-. ��.� 'T' �' �--�.�- �
<br /> �'�"'f��J� � �Owner Phone Number
<br /> Fee Simple Titleholder Name r ,.�. ,�, -
<br /> Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ��I � � �� /
<br /> �� � + r �'[ LOT# �/C
<br /> � �
<br /> SUBDIVISION S�i 1 L�•G/'G �� pARCEL ID# ''�:��'�� • _ -
<br /> � �f7(C�' C �
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT � 51GN
<br /> '� ' � 1 � I 'INSTALL e REPAIR � � DEMOLISH
<br /> PROPOSED USE �� SFR � COMM
<br /> lYPE OF CO.NSTRUCTION ��' BLOCK � OTHER
<br /> 0 FRAME � STEEL � •
<br /> DESCRIPTION OF WORK ���L� j�� � 1 �
<br /> ���•��n-Ll �, �_�'S',)�:k�,'�r 'L /
<br /> �Gc�v-� �2�-:"1-t-; r -.r��-Y
<br /> 6UILDING 51ZE SO FOOTAGE I��Z �
<br /> 'T'e-rr�-r-�-r-�-r-T- H E I G HT
<br /> �'8 U I LD I N G �-`�_rr�r-�e-rrr-e-rrr-rp-9-ti-re-s-rrrrv-'r-°�-rrsT°-�-r-e-ru--�"'ra-Q-v�-e-�-u-a-8-u-o-r-
<br /> Q �J�� VALUATION OF TOTAL CONSTRUCTION
<br /> 0'ELECTRICAL $
<br /> � ��� AMP SERVICE � PROGRESS ENERGY
<br /> / � W.R.E.0
<br /> �-PLUMBING � '
<br /> � , �� 2�>� .
<br /> �'MECHANICAL $ �j VALUATIOfV OF MECHANICAL INSTALLATION
<br /> L-�/ iJ�'�,
<br /> �GAS �� ROOFING � SPECIALTY ,
<br /> � OTHER
<br /> FINISHED FLOOR ELEVATIONS
<br /> • �,�� FLOOD ZONE AREA �YES NO
<br /> ^�_F-#-8_�-�,-i--4-F-14_�-i-6_F-{--i- lJ
<br /> a-G--e-o--a-o--�-a--4-�s�-a-a-a--a--P-�--a-�.-�-s�-r-a�-6--a-9--:-a-�-s�.°a-o-:-e-�-�.�sm,^,-��-e-�-�-e-�
<br /> BUILDER
<br /> SIGNATURE � -' - "� COMPANY �.. � „ �-, �,,�;.�_�,�„� �-�,L�
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address %��c7v� l���<O.� .� r" )�i�� c..
<br /> License# ��C�G�'�'j C� f, ;�
<br /> .�LECTRICIA�V A
<br /> SIGN;qTURE � �s'2i`"`^''..� COMPANY ��a,�`l?,C?nr7,.�"',�,�T �f''r,`.�.7i1�..� �,.
<br /> • � � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address 4��..�y,Qj M����'"C'� �.
<br /> �"`� � ��� � �� '��c.� / �,�J,
<br /> � Lfcense# �,�:
<br /> PLUMBER /
<br /> SIGNATURE � �� _.. . .... — COMPANY , ��...��d,l�,f. ..��,��G"�,��:�-,�:.ra ������;r�j�.�� �
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address �'�C1�'__�f�'�� T,�� ,I
<br /> t�/l��'r �.���� .� License# ����,� ���, "Qr /'
<br /> MECHANICAL ��^
<br /> SIGNA7URE f„f `�.•�..-�;_""-'^C/�,...,�...m__��-__ COMPANY "��A",�fi(',i7,�`��„f;,���{�'�' �'',�- ,� � „�7�er,,•?..fi'
<br /> - �REGISTERED Y�"/ N FEE CURRE� Y/N
<br /> Address ���r-7� ��-�.-,��.�^ �x� f^'ue�a,.a�'�rt�,Lf�e��j�
<br /> _ License#' �������� �'
<br /> OTHER -- .' ,,.l.,
<br /> .
<br /> SIGNATURE � �.-�--�„�-�-- � . ,_� ti
<br /> --^�-- � COMPANY 1'�A�t,���,�J��-.�i.�i��/r,�,�' :��r���ra-�
<br /> 'd ,�-� FEE CURRE� Y/N �"
<br /> REGISTERED Y/ N
<br /> Address /�a'���!�� ,� f �i`' ���,,,=�, ,
<br /> 1 1 1 1 1 1 1 1 1 1 1 1 1 i Q 1 1 1 1 1 0 1 1�1 1 1 I I 1 I L I 1 E L 1 B 1 7 L 1 I 1
<br /> License#
<br /> RESIDENTIAL Attach (2) P l o t P l a n s; (2)s e t s o f Bui l d fng P lans; (1)set of Energy Forms; R-O-W Permit.for new c n truction,B � B � B � � p p p
<br /> Minimum ten (10) working days after submittal date Re quired o n s i t e, C o ns truc tion Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanit a r y F a c i li ties&1 dumpster;Slte Work�Permit for subdiv(sions/large projects
<br /> COMMERCIAL Attach (2)complete sefs of Building Plans plus a Life Safety Page, (1)set of Energy Forms. R-O-W Permit for new construction.
<br /> Minimum ten (10)working days after submittal date. Required onsite, Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facliities&1 durimpster Site Vliork Permit for all new projects.All commercial requirements must meet compliance
<br /> S►GN PERMIT Attach (2)sets of Engineered Plans. �
<br /> '•''`"*PROPER-fY•SURVEY required for all NEW construction.
<br /> D f;e tf o n s-4-d-b-.u_�"g_�-0-�-�--4-�e-8_L-G�_
<br /> Ffll out application completely �������������'��"�"�'�-�0-�'�H--t�9vp...gmp_p�
<br /> Owner�Contractor sign back of application, notarized
<br /> If over$2500,a Notice of Commencement is required. (A/�uP9rades over$7500) � -
<br /> "' Agent(for the contractor)or Ppw�r of Attorney(for the owner)would be someone with notarized letter from owner auth • I
<br /> �VER THE COUNTER PERMfTTINC
<br /> 3eroofs If shingles Sewers �, �°OPy of contract required) orizing same . '
<br /> ,ervice Upgrades A/C Fences (Plot/Survey/Footage)
<br /> Driveways-Not over Counter if on�ublic roadways..rieeds ROW , • �
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