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, e13x�ao-oozn City t�f Zephyrh611s Permit Application Fax-813-780-0021
<br />� , 8uitding Department �
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<br /> Date R�celved P!�one_�an�cf for Permit�in
<br /> Owrner'�NaQne S r`�ZYlGV" Owner Phone Number �( 3 ���� "' ���� �
<br /> Owner"s Addres� �'J' 30 3rd �� - Owrrer Phone Numb�r � �
<br /> Fea Slmple;T'itleholderName � • � Owrner Phone Rlumb�r �� �
<br /> Fee Sirnple�Tltleholder Address
<br /> JOB A�DitESS 530. o`�3`� �� - �C 'l 1 S �j-- ��`J``�c3 LOT# ��
<br /> �ueatv�s�vra t '�.�,�� �bRCE�.t� .
<br /> �,J (OBYdIP1ED F.R41�,PROPERTI!YAX IVOTICE)
<br /> W4RK PR�POSg� tVEw CONSTR ADDI�i:'f �� SIGN [� � pEMOLtSH
<br /> , �/ . INSTAI.L 8 REPi41R �
<br /> PROPOSEDr01$E � SFR Q COMNI [� QgHEFi
<br /> TYPE OF COWSTitUC'fIOPI Q� 9LOCK " [� FRAME �Q STEEL [�] ' G 4�A
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<br /> DE�CRiPI'i�lN�F WORit �N13�"h�I I 1�"1 r C1rta; rti t�r�K �i�` Yt e. D C�:
<br /> �UIL�I�IG�lZE � �1"84��OT�GE��; � HElGHT ���� ,
<br /> QBGII.DING � Q��� � VALU�4TtON£G)F`TOTAI CON57'RllCTIOiV `
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<br /> QELECi'Ft1GAl: $ ' A�P SERVICE Q Pfat?GRESS ENERGY Q W.R.E.C. I
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<br /> QPLUMBINt3 � � ` '
<br /> [„�MEGHANlGA4. $ VAL"URTlON OF,MECMAPlICAI INSTALIATiQN `�, `
<br /> , . A ! �
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<br /> (�GAS [� i2QOFING .Q SPECIA�.TY [�,� OTHER -
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE A,REA QYES. ,NO
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<br /> BUILD�R � C�t�flPAFlY�� ' �{��U1R. t��1L�1-�� . �
<br /> I S1GNA7l9RE REGI&TERED Y/ N FEE CURREI: Y/N
<br /> Address Ltcense# �� �
<br /> J - ,
<br /> E�E�TRtGF�uM1I ?COAtIPANY
<br /> SIGNA'PURE � REGISTERED Y/ N FEE CURREF�' 'Y/N
<br /> Addr� - . license.# � � �
<br /> fPLUMBER � � COMP�ItdY � , - + ° .
<br /> S1GNI�TURE' � , REGIS7ERED, Y/�.N•; FEE CURREP Y/N �
<br /> AdcE�ess � . - � tscense.#�, - . �
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<br /> N1ECN�PI(GAE: ' CQ�tt�ANY " � , '
<br /> �IGPiA7�41RE i REGI,STERED . Y�/ N �,� FEE;CURRE� , X,/,=N'
<br /> Addre�s ' � - ' . License#���. . ,�. �
<br /> OTHE� CQ�9IPAAY�iY ,
<br /> $IGNlA"Pl)RE `=' . � � � ' ` REGISTERED� Y/ N.._;` FEE CURRE� Y/N
<br /> � Addre�s � - , _ Cicerise# � � � -
<br /> E2ESlDE�tTiAl:;: � •Attacli�(2j„PtofPfans�.(2}set`s=of�Buitdirig�Plans;(1}`sefof-Energy:Forms�R=O=W°Permitfornewi�nstruction, ' +
<br /> , ::MiNmum,�ten._(:1,0):working;da}rs;after subtnittai date. Requtred onsite;-Construction'�Ptans;Stormwate�'Pians°w7 Slit Fence 3nstai�ed,
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<br /> Sanitary FaciltUes;&:,1;,dumpster=Slte Work.Permit for su6divisionsAarge project$ � •a
<br /> CQEVfIUl�RC1AL Attach{3)�c8mpl�te sets pf 8u1li31ng P1'sns plus�a�Llfe Safe#y Page;{1}set of Energy Fomts.R-t?W Petmlt#o�new construction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Constructlan Plans,Stormwater Plans w!Siit Fence instaUed,
<br /> Sanitary FaciliHes&1 dumpster.$ite Work Perrrrit for all new�projects.All commercial eequlrements_must meek compliance
<br /> S1GN P�63Mi1' Attadi{2}sets of Ersginee�ed�Plans.;: .:- �- `
<br /> ••"•PROPERTY SURVEY reyuired for all NEW canstrucdon.
<br /> Dlr�cftlons: � �,
<br /> Fill out applicaUon completely.
<br /> Owrner&Contraotor sign back of appl[catlan,natadzed
<br /> tf aver$2500,a t�aticg of Comman�ment is aequirec6. {A►C ap�Pades aver$7500)
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<br /> '" Agent(for the contraator)'or"Povirer of Attbmey(for tfie awner)would be someone with notarized letter from owner authorizing same
<br /> dVER 7H�COUE�T�R.PE�2Mi'�'FI�1� - {Front a€Application Only) ` � � �
<br /> Reroofs if shingles Sewers � Servioe Upgrades,A%C Fences(PIoUSurvey/Foatage) , '
<br /> �trivawrays-Not nver Counter If on public roadu+ays..i�seds l20W "
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