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8'13-780-0020 City of Zephyrl�ilis Permit Application Fax-813-780-0021
<br /> • " Building Department
<br /> Date"Receiv2d ' �;
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<br /> Phone Conta�t for Permitting "1 �'�T r`�'�a�`a'��`� � � �`� °'��•����
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<br />, Owner's Name � �.� ,. a � � Owner Phone Number / 1 �
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<br /> Owner's Address ���Q���I�e c=� ,r f�,.r 'TG��,�c j�� >•-�"-) '
<br /> . � � /Owner Phone Number • i
<br /> Fee Simple Titleholder Name c ,.�. ,� I
<br /> , Owner Phone Number
<br /> Fee Simple Titleholder Address �
<br /> JOB ADDRESS rjL��j ' �,`rC \ ` /� r
<br /> . � `} ,`� • s � � I �� LOT# �
<br /> SUBDfVISION �i�� L�•G�'� � /
<br /> � PARCEL ID# �� ' "'r:��-���� J -(� ��`����
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN
<br /> ' � ��'INSTALL e REPAIR 0 0 DEMOLISH
<br /> PROP05ED USE �� SFR � COMM �� OTHER
<br /> TYPE OF CO.NSTRUCTION ��' BLOCK � FRAME � STEEL � •
<br /> DESCRIPTIOIV OF WORK O��L� J�� 1�•�'��� � � � L'
<br /> �Y''P L ��_�d� �, zr
<br /> -� f ���:�z��:��a� i �����.
<br /> BUILDING SIZE SQ FOOTAGE �pZ� Z •�
<br /> Trrr�-r-u-�-r-r.-r-.�_ H E i G HT
<br /> r-�-r-r-�-�-r-e�-rr-r-rr-r-e-s-�r-�--o--o--e-e-re-Q-r-r�-�--y-i-o--r�-��-0-9-�-e-e-v-ra-e-e-a'-�-o-i-
<br /> �'13fJI,LDING �
<br /> �� ;�� VALUATION OF TOTAL CONSTRUCTION
<br /> Q.ELECTRICAL $ ,
<br /> , j��v AMP SERVICE � PROGRESS ENERGY
<br /> � W R.E.0
<br /> ��UMBING � '
<br /> � Cl'U �
<br /> [�"MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION v�
<br /> � ,� , �� .
<br /> �
<br /> GAS
<br /> 0 � ROOFING � SPECIALTY � OTHER •
<br /> FINISHED FLOOR ELEVATIONS `
<br /> }�)`��� FLOOD ZONE AREA �YES NO
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<br /> BUILDER •;�
<br /> SIGNATURE � � - '� COMPANY :IJ� � .. �-� v ,_;.�_�•�,--� �"1,L�
<br /> REGISTERED Y/ N FEE CURRE�
<br /> _ Address �����,� %_/ Y/N
<br /> �'<� .� .� r^ )c�i7�� c..
<br /> License# ���C�,��j C� f, ;�
<br /> .�LECTRICIAN ���
<br /> SIGNATURE ��'`�"`-'� COMPANY ��,�'j`1,CJn�7,�,3'",p'„� ,���,��1^�, �
<br /> • • REGISl'ERED Y/ N FEE CURRE� Y/N
<br /> Address � 4�d.�yJQ�t��F'�,�"L� �,.,,,� � �f �
<br /> License# ���,�������,�
<br /> PLUMBER /� ,�/ / ,,�'+
<br /> SIGNATURE ����"� t�� — C�MPANY � f'" ���'"r��,(�,�` •.��,�•G"s�,�.3'.L-,�� F"��,rJ��r�7��'a �
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address �����(� '"��
<br /> � � � `"�'��� � License# ��k�� �F;/r� ��
<br /> MECHANICAL �
<br /> SIGNA7lIRE �"a"��:,'_-..-=-C.��,m�-�_____ COMPANY �A`�1�(',i�/`��,fl,j-G��,��' �d�- ,�:� ,�7�e�'.�.Jl"
<br /> �REGISTERED Y�`/ N FEE CURRE� Y/N
<br /> Address ���7� �F.-�.-„��,,, �
<br /> _ �C'� f���,.�f^�,•�,C'J`�:.,��j-
<br /> , License# ���������
<br /> OTHEFi ' .,r
<br /> SIGNATURE � ' �rR'- -�-- --�--�—' COMPANY � f �i /�
<br /> - -�/�-. .. �, f jA Y�.l,N,�1�j-../�'ri/1�/�i� :�-��(��-��ra-�
<br /> I p �^-� FEE CURRE� Y/N �"
<br /> R EG I STERED
<br /> Address F ���/'!--.3 ,� �1�� � ���.
<br /> �.: �
<br /> 1 1 L 1 1 1 1 1 1 1 1 1 1 i I 1 1 1 1 1 7 1 1 1 p 1 1 1 1 1 7 L 1 1 1 L L 0 1 1 6 1 I 1 1 1 IIC7 059 0 p 0 Q 0 0 � B � � 6 a � � B � �
<br /> RESIDENTIAL Attach (2) Plot Plans; (2)sets of Buildfng Plans; (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/Siit Fence installed,
<br /> Sanitary Facflities &1 dumpster;5ite Work Permit for subdivisions/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 constructlon.
<br /> Minimum ten (1 D)workfng days after submittal date. Required onsite,Construct(on Plans,Stormwater Plans w/Silt Fence fnstalled,
<br /> 5an(tary Facllities &1 dumpster.51te Vliork Permit for all new projects All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach (2)sets of Engineered Pians.
<br /> *"**PROPERZY�SURVEY required for all NEW constructlon.
<br /> IDirecYfons:
<br />, FII�I out aPplication�com�te��_�_�-�����e...¢-�B...g-d-.g-�--�g-�4"'�"��-�-�-�&-�e�A�p��=-a-8-�..6_b�.
<br /> Owner�Contractor sfgn back of appifcation,notarized
<br /> IP over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
<br /> "` Agent(for the contractor) or Power of Attorney(for the owner)would be someone with notarized letter from owner aLthorizing same
<br /> t
<br /> �VER THE COUNTER PEFiMITTING
<br /> �eroofs if shingles Sewers �, �COPy of contract requfred) �
<br /> , ,ervice Upgrades A/C Fences (Plot/Survey/Footage) - .
<br /> Driveways-Not over Counter if on�ublic roadways.rieeds ROW � . � - �
<br /> , ` � � .
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