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e•1�-�so-oo2o City of Zephyrl�ills Permit Application ,, Fax-B� so-ooz7
<br /> ' Building Department ,���
<br /> Date Recefved_ �
<br /> TI-1-1TI7—�—
<br /> PhoneContactforPermitting. `"��"'�`�r"�'� ��'�a��''� �'�� �```� °'�°�.����
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<br /> Owner's Name � -
<br /> � �'� o ^ � Owner Phane Number ,�L��-�, � �(a �
<br /> Owner's Address ���Q���I� c=ra ,n.-. ��,� "T" �• ,.-�2- I
<br /> �'�D"f��J� � �Owner Phone Number
<br /> Fee Simple Titleholder Name c �,,�. ,� ' ' -
<br /> Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �Q S�Z �CQ► S 2
<br /> , �S S LOT# J
<br /> SUBDIVISION S i�l U•G�'C � PARCEL ID# �� '`r-f�-��-.- _
<br /> c_'a
<br /> WORK PROPOSED (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> NEW CONSTR e ADD/ALT � SIGN
<br /> � � 'INSTALL REPAIR 0 � DEMOLISM
<br /> FROPOSED U5E . �� SFR � COMM
<br /> TYPE OF CONSTRUCTION ��' BLOCK � �THER
<br /> 0 FRAME � STEEL � •
<br /> DESCRIPTION OF WORK ����� '��� p�
<br /> � .� ��lc•�'�n-,_1 L j=�5�'� k ] `
<br /> dG �."C.Z= � �JCc:� ����:'G'I-1 a�c�_'�-`.
<br /> BUILDING SIZE SQ FOOTAGE 3�53
<br /> "�e'r'r�-r-e-rre�-r-n-�.�-. HEIGHT '
<br /> r-r-^P-r-�-ra-�-r-r-i-. r-e-c-P..r�_re-Q--r-P--e_e'-y-ro--o-�v-
<br /> �B U I,LD I N G $ e-�-r-p��-��-����
<br /> `�j �o VALUATION OF TOTAL CONSTRUCTION
<br /> �ELECTRICAL ' $ AMP SERVICE
<br /> $ (�� � PROGRESS ENERGY � W.R.E.0
<br /> �PLUMBING � .
<br /> � Sb0 � �`�
<br /> [�MECHANICAL $ ��
<br /> �� VALUATION OF MECHANICAL INSTALLATION � ��
<br /> �GAS • � ROOFING � SPECIALTY
<br /> FINISHED FLOOR ELEVATIONS 0 OTHER •
<br /> f FLOOD ZONE AREA �YES NO
<br /> ""q-a-'a-�--�-F--0--�I-F-6-i-1-_p._F-p--E-a_ � .
<br /> �-�-a--°-a-a-.°.-.;_.B�G-6-o-F-q--,1--6-0--�-�-a-�..6..�;-a-.6�-�-..�--a-.�s-�9-�n-0-a-�G�B�-.C-��9-e�-i_e-�-
<br /> BUILDER � •�� '
<br /> SIGNATURE - "��_ COMPANY �.. � _ �;-, ��;.�_�,�,� �-1,L�
<br /> REGISTERED Y/ N FEE CURRE�
<br /> Address � �����,� %�/ Y/N
<br /> �<O.� ,� �" J�it� � •
<br /> License# ���C�,��j C� (, ;�
<br /> .�LEC7'RICIA�V �,
<br /> SIGNATURE � �-��'�''� COMPANY � r , '�'��; �
<br /> �C� ���`l?�CJn 7.F"�',�1� ,C:.��'��!",� �C:
<br /> REOISl'ERED Y/ N F.EE CURRE� Y/N
<br /> Address d��.�y,��'���'"�'� ��
<br /> � � `�� License# ���,��,������'
<br /> PLUM6ER ,�/
<br /> SIGNATURE ����"'� -_._ ._. — COMPANY ' ��'�'",r�,t.,(?,1` •.��.�•G's�,��;if,��..�i ��,G�li,2'�;�,���r� �
<br /> REGISTERED Y/ N FEE CURRE�
<br /> Y/N
<br /> Address �/ / �
<br /> (, f��''� T(��(„r/�- . a �,'��j����''� IL�F`�!�-., � �
<br /> � License# r , .��
<br /> MECHANICAL � ' '
<br /> SIGNA7URE �`F'��:'r..�--^�..��m�_ COMPANY �A`��',i��`�,r,j"yJ�{/,�*' �a'�- ,�� .j'T��."�.Jl�
<br /> 'REGISTERED Y�'/ N FEE CURRE�
<br /> Address • ���-7 ` Y/N
<br /> � ,/��'Jr^,�a�.�.- �x� ��'J�'a...���c•t��J`c�i f,
<br /> License# ���•������
<br /> OTHER , -- ^' � - '
<br /> SIGfYATUflE � �--��"�.,.�' �-- `-�•� ��
<br /> _..-.�-.—- ,/� �
<br /> COMPANY ]°)O�1;f"�f� , ..�j�' / ) � yA �,,� .
<br /> 0�' . .� ,/.f1�;F :,._�J��(�'�-�^�-f'
<br /> � REGISTERED Y/ N �"
<br /> 1!d��d ��,` � � FEE CURRE� Y/N �
<br /> Address a, � rpir �.�,. '`,�' '
<br /> Nf /"� ��'���A�
<br /> 1 1 1 1 1 1 1 1 I' 1 1 1 1 7 1 1 1 ! 1 i 0 1 1 1 0 1 1 I 1 1 6 1 1 1 1 L L 9 i i L 1 1 1 1 1 1 7 i 1 .1 ➢ 1 0 1 9 9 � 9 B L 9 p B E
<br /> License#
<br /> RESIDENTIAL Attach (2) Plot Plans; (2)sets of Building Plans; (1)set o f E n e r g y F o r m s; R-O-W Permi t for new construction,
<br /> M f n l m u m t e n (1 0)w o r king days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster;Site Work�Permit for subdivislons/large proJects
<br /> COMMERCIqL Attach (2)complete sefs of Building Plans plus a Life Safety Page; (1)set of Energy Forms. R-O-W Permit for new const
<br /> Mfnimum ten (10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> San(tary Facliitles&7 dumpster Slte Work Permit for all new projects.Ali commercial requirerrients must meet compliancection.
<br /> SlGN PERMIT Attach (2)sets of Engineered Plans.
<br /> *"*"PROPERTY•SURVEY required for all NEW construction,
<br /> '�"�-a-a-�,--�-8--e._
<br /> Directions; �-�-��-a-e-8-4�_ '
<br /> Ffll out appllcation completely ����������-�-��'"d"B"��°-�-�-�-fl��p�_@�g_���
<br /> Owner�Contractor sign back of application,notarized
<br /> If over$2500,a Notice of Commencement is.required.
<br /> "` Agent(for ilie contractor)or Power of Attorney(for the owne(�ou d9be som one w5h�n)otarized letter from owner authori '
<br /> �VER THE COUNTER PEqMITTING
<br /> �eroofs if shingles Sewers ;, �00PY of contract required) zing 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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