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a13-7$a-aoao City of Zephyrhilis Permit Application Fax-813-780-0021
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<br /> - Building Department
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<br /> Date Recelrred z-��"j � ; .phone Contaat for Perm�tting – ��
<br /> 4wner's tV�me ��/n 6�T �!U G�� Owner Phone Number f '" / ��P Y rG' �
<br /> Owner's�lddress �� � i -G `L .�, .S Owner Phone Number �— �
<br /> Fee Simple Tittehotder Name � 4wner"Phone ldnmber �! �
<br /> Fee Simpl�Tttleholder Address
<br /> JOB ADDRESS � S� ' 'C�� ��- � � LOT# �
<br /> SUSD1VlSlON PARCEL.ID# 2��''�'G"d�J'"����'` 3��
<br /> � (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED . NEW CONSTR 8 ADD/ALT Q SIGN Q � Q DEMOLISH
<br /> � INSTAL� REPAIR
<br /> PROROSED USE SFR Q Ct3MM � OTHE12 ,
<br /> TYPE'OF CONSTRUCTION BLOCK - Q FRAME � STEE� Q '
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<br /> . ��sc��Q�a�oF woR�c b /' �
<br /> BUlLCIlNG SIZE ��� r� SQ FOOTAGE� FlEIGHT ����
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<br /> QBUILDING $ '�Da� .� VALUATlON'QF TOTAL CONSTRUCTlON I
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<br /> QELECTRICAL �i � AMP SERVIGE Q PROGRESS ENERGY [� W.R.E.C.
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<br /> QFLUMBING $ �f� I ` ��1/////�/��
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<br /> QMECHANtCAL ��� VALUATtt)N dF MECHA{V}CA�INSTALLATION � ,. )���
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<br /> ��GAS Q ROOFWG Q SPECIALTY [�, OTHER ���,,����. „ �'4
<br /> FINISHEa FLOOR ELEVATIQNS FLOOD ZONE AREA QYES N4 ���� _����
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<br /> �BUILDER ? � �c� COMPANY
<br /> SIGIdATURE p�"��<�'/IC REGISTBREp Y�I N �e euRREn Y I N
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<br /> Addre'ss ticense# � �
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<br /> �"'ELEC;TRl,ClAN $ ., COMPr4NY �
<br /> SIGNATURE REGtSTERED Y I N FEE CURRE� Y/N.
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<br /> � `Ficldress l.icQnse# r—�!�
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<br /> RLUNlBER.�. COMPANY '
<br /> -SIGIVATURE, REGISTEREQ Y/`N� FEE CURRE� Y'/N
<br /> �ddress � ' Licerise# �!� �
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<br /> ''.MECHAIdIGAl: ' � COiNP.ANY
<br /> "` SIGNATURE"" REGISTEREp , Y/ N FEE GURRE� ,.. . Y/N, '
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<br /> Aiidress=�=' � ' Licens.e.# � �
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<br /> .e_.07HER::_ _':.- � ' COt�fi,P,�ANY -
<br /> ,,"SIGNATWRE��:.._- .� � Re�isr�Rep � Y 1 N �e cuR�n� Y!N
<br /> � .Aiidre'ss�., _, .tr;. _ � . , � Licerise# � I
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<br /> ,:REStDENT1A4.ys,.: ';Attach.:(2);:PI�ti;Plans;`'(2):"sets�of�Building�Plans•,'`(1�)`set'ofEnergy`Forms;R=O�W.Pe�ilt�or neW.constiuction,
<br /> �-u>4,-�=��, �Minirnum:ten�(,1Q)eworkingtdays:afte�submittal�date.�Requi'red"onsite;'Constniction`Plans Stdr�t�water;Ptans rrvl Si1t Fence instslled,
<br /> ; ti.w�t.'�•�.,a. .. ,�: � � . . _ ,.
<br /> 8anit�.ry�Facilitie,s;&c:1�;dumpster;�S��#e.,,.W,or,k.Permitfoc:subdivislonsilarge`.p'roj�cts:� � � ' �. �
<br /> ��COMMERCIi4L Ak#acti`{�)�aoriip�ete"sets'of 8u�lding 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 qnslte,Construction.Ptans,Startnwater Plans w/Silt Fence installed,.
<br /> =a - Sani#ary Facilities&1 dumpster,Site Work Permit for�aii new-projects.Ail cammerciat requirements must meet compiiance
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<br /> °.�.ASIGN.PERMIT 'Attaati��(2}`sets::of,Engineeretl F'lans:,r .: - . .
<br /> 'Y,-":�F ***"PROPER71!SURVEY requlred for aII.NEW construction.
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<br /> '�'�Glicections: , ,_ . , - . . , , {
<br /> � '� Fill:nut appl3cat3on completely.
<br /> Owner`&Contra�tor sign back of applicatian,nota�ized
<br /> , If over�$2500;a Notice.af Commencement is required. (AfC upgrades over$750Q)
<br /> . '*" .Ageht�(for°t}ie=conti�actor)=or°Pawer o#Attomey{for the owner}wouid be sameone with natarized letter from owner authorizing,same„__,
<br /> ��;t'?VER`:THE COUNTER:�PERMtTI'lNG. .. (coPY.;of cantractcequtreiij : �` ' , ; , . �
<br /> `"'F2eroofs.if stiingles Sewers Seroice,Upgrades;A/C Fences(PIoUSurvey/Footage� . � �
<br /> Driveways-No#over Counter if.on public_roai3ways..ne,eds ROW ., ; ry ' ' , r
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