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S�a-�so-oazo City of Zephyrhiils Permit Application Fax-813-780-0021
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<br /> Date Received , �._.__ "�� '
<br /> - - ---�, Phone�Contact for Psrrnitting -
<br /> Owner's Idame Owner Phone Numb r �� �'v �S� .
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<br /> Owner's Address,. ner Phane Number
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<br /> Fee Simple;Titleholder Nafhe ��. - � Owner Phane Number ��
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<br /> Fee Simplel Titlefiolder Address � G�-�+ 'r- �S �. �U�,.�
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<br /> JOB ADDRESS � Yl.=, � LS v S � ' LQT# (�i d ' b
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<br /> i (OBTAINED FROM PROPERTY TAX NOTICE)
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<br /> WORK Pl2QPQSED . NEW tONSTR ADD'1,4�T C� SIGN [� � [,� DEMO�ISH
<br /> ; e INSTALL 8 REPAIR
<br /> PROP,QSED USE Q SFR Q CO(uiM C� OTNER ,
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<br /> TYPE'OF CONSTRUCTION Q BLOCK • [�. FRAME � STEEL Q
<br /> DESCRIPTI�,ON OF WORK —�-�Z- ��� ��'�-E�- �-�-Q� S Yln.�
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<br /> BUI�DING BtZE �_ � SQ FOOTAGE C� HEIGNT -
<br /> r � �� VAI.LIATiON`dF TOTAL CONSTRl1CT10iV
<br /> BUt�.DtNG ri �
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<br /> QELECTR,ICAt.. ���� AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C.
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<br /> QP�UM8ING ($ �
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<br /> �]MECHAN{Ct\L �� � VALUATlON OF MEGHARfiCAL lNSTALLATION
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<br /> QGAS � ROOFENG Q ,SPECIRI.TY � QTH�ft
<br /> FINISHED FLOOR EI.EVATIONS C�` �� '� FLOOD ZONE AREA �YES NO
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<br /> BUI�.DER ; COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CUFtRE�. 1(/N
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<br /> Address ticense# �� �
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<br /> ; 'ELECTf21,C1AN ,_. COMPANY
<br /> ,. SIGNATURE REGISTEREQ Y/ N FEE CURRE� Y/N
<br /> Address' License# � � �
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<br /> PLlJiVIBER:?.:; r CQMPAIVY .
<br /> -SIGNATURE _ RE��sreREo Y,=/`N:' FEE CURRE� Y/N
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<br /> �Addregs - License#-�� �
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<br /> - MECHANICA� . COMPANY
<br /> SIGNA7URE`` � REGISTERED. ,' Y/ N - FEE.CURRE� Y/N -
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<br /> Aiid�e'ss�:. ` License.# � �-
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<br /> .,` OTHER;� P��: � �— GQtU�PA1dY �C...0 C��t d-'1�d3-h, C�� -
<br /> `G'SIGNATURErtp ��• � REGISTERED Y I N F CURREK Y I N
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<br /> Address� , . ? - ,_ _ � � ° Licerise# � L��j,G$`�.� �
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<br /> :�KRESIOENTlAi.�;« Attach.{2);Ptot�Plans;:{2�>seCs`of�8uilding�Plans;{1)`setof Ene�gy,Forrtis;R=O-W Permlt;fornew.canstivction, � .
<br /> --.w;�.,�,:.µ.�•���,Minimum;;ten;.(,1Q)j.working'sdays:aftersu6inittal:date..°Requi�ed`o'nsite;Construction Plans,`Storinwater Plan"s w/Silt Fence installed,
<br /> Sanitary,FaciNties&1.du,mpster;:Site,Wp[fePermitfor.subdivisionsflarge:.p�ojects�.-� ' ' �"
<br /> My'COMMERCIAt. Attacit{2)�complete sets"of�8iialiiing Plans plus a�t,ife Safety Page;(1}set of Energy Forms.R-O-W Permi#for new constructian.
<br /> . Minimum ten(10)working days after submittal date. Required ansite,Canstructian Plans,Stormwater Plans w/Silt Fence installed,
<br /> ���;;, SaNtary Facillttes&1 durnpster.Slte Work Permit foF�all-new projects.Rii commercfal requirements,must meet cotnpliance
<br /> °:~.SI'GN�PERMi'P AftacFs°{2jsets-�of;Eng�neerec3`Plans:�c° �
<br /> *"""PROPERTY SURVEY required for aII.NEW construcUon. .
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<br /> "DIfBCt�ORB:. �.s _ . „
<br /> ` Fill out;application completely. �
<br /> O.inrr�er:&�Contractor sigrt baak af application,nafarized
<br /> �- {f over$2540,a Notice af�Gommencement is required. (A!C upgrades over$750Q)
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<br /> •. AgenY(for�the�cont'ractor)�orPower'of'Attomey{for'ttie ownerj would tie someone with notarized letter from owner authorizing same
<br /> ;;,OV.ER.THE COUNTEFt�PERMi'iTiNC. (copy of contract�required} "
<br /> '�=Re�oofs�if,'stiingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
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<br /> ;Drivavyays;Nof a�er�Coun{er�i��on pubiic:roadways.neecls ROyV'
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