|
8'13-780-0020 ' City of Zephyrl�ills Permit Application Fax-813-780-0021
<br /> • � ' ' Building Department
<br /> Date Received „���,r,.�.,.���^. ,' �^-� � �'� �, ��m,�,���l�•3
<br /> �-�---r-�--r-�- Phone Contact for Permitting "r ���`�'�_ f�
<br /> r
<br /> Owner's Name � � �, �. a � � Owner Phone Number �� ,�Ll�-�. � `r'',?(a �
<br /> Owner's Address ���Q����e cc� ,rr-� ,.r � '��'2-
<br /> , � T�`�"�'��J� � .�Owner Phone Number
<br /> Fee Simple l"itieholder Name �, ,.,�. .�
<br /> Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS n �7�'I . � ��C1 "'� (i�C JI{7 L�(.��� f+ � f/ �
<br /> � � �`t_ c � `► LOT#
<br /> SUBDIVISION S i�l 1,•G�'G �� PARCEL ID# '(-f�-�A� �1 -Z;��)��'v�� `�
<br /> (06TAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPDSED NEW CONSTR ADD/ALT
<br /> � SIGN � � DEMOLISH
<br /> • 'INSTALL
<br /> ' � REPAIR
<br /> e
<br /> i FROPOSED USE �� SFR � COMM � OTHER
<br />� TYPE OF CO.NSTRUCTION �� BLOCK � FRAME � STEEL � •
<br /> DESCRIPTION OF WORK O��L� J�� I p�, , E 1
<br /> /��C��rY�.7 � ���d��k�•.�� 'L` h`-J G c:� .�u:��:'�-1-1 -��c�-ti�.
<br /> /
<br /> BUILDING 51ZE SQ FOOTAGE l��y /�/�
<br /> -T-�-r^-.�rr.�_ �t HEIGHT ' -
<br /> �-r��-r�-�-r-P-�-r'-a-rrr'�-e-e-�a-r-�-re-e-e-r�e=r�-s--u'-�-a--r��-o--rvP-y-�-e-P'-o-Q-Q-e-e-e-e-a-�^
<br /> �UILDING $
<br /> j�J Cy�,� VALUATION OF TOTAL CONSTRUCTION
<br /> �ELECTRICAL y AMP SERVICE � PROGRESS ENERGY
<br /> � �.� � 0 W R.E.C.
<br /> �V/PLUMBING � �
<br /> , ��
<br /> �ECHANICAL $
<br /> � � � VALUATION OF MECHANICAL INSTALLATION
<br /> �GAS �� ROOFING � SPECIALTY � OTHER '
<br /> FINISHED FLOOR ELEVATIONS
<br /> `J 2 �C}/ FLOODZONEAREA �YES NO
<br /> L_..
<br /> ^'p"p-7--i--9-�--p-i-F-�F--O-F..�p_p-i-i-O--C--0--C-B--0-j-�--6--�--6�-v-C--�4-6-�--��6-�3-F�-�-9--8-6�9--➢-:-a-S-�0a8�-�--a--F-,1--C--�P�M1-
<br /> BUILDER
<br /> SIGNATURE � � -''� COMPANY �� � _ �,-, �,•-s�-��,-� �"J.,,�
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address /��C�v� /���-CO.�+-� ,� r^ )�i�� � �
<br /> ' License# ������j C� !, ;�
<br /> .�LECTRICIA�I
<br /> SIGNi4TURE � �/��'"`''.� COMPANY ��'�,�`Z'i',C)n�,�,7'",Q,,c? ,���`�"q��;�^,� l�
<br /> . , REGISI'ERED Y/ N F.EE CURRE� Y/N
<br /> Address d�d.��,j������`"ti- �, �
<br /> � '`� "�.� �� ��'�J�'`.
<br /> ,, • License# �,�: ���
<br /> PLUMBER �� , ��— / �
<br /> SIGNATURE ,,'`�'✓�" .... COMPANY ' '��'���,(?,�` •.��.�•G'�,�.2;�fi'�i ,�'��i,rJ'y�,��,�"a . �
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � ���� T��-�f�'�- ���.���,'� iL�k�� �G�
<br /> License# r . ��
<br /> MECHANICAL � � �
<br /> SIGNATURE �ta'��:'_-�=-�"G/�..�� COMPANY ��Af�(',�,/`�'�;,f�,3��,{,I�' �d�'- ,�.� ,i'T�,rr�^�.J�"
<br /> �REGISTERED Y�`/ N FEE CURRE� Y/N
<br /> Address • �`e�r�r-7� �,�-J'"��,�^ �x� f�`u��,..a�^�r1.rt�,�.l`�-�.A�!�
<br /> j� License# ���������
<br /> . �
<br /> SIGNATURE ¢� �,-�' --�^'�-" COMPANY J`)/1�{,r'�� y/��/ � � ..� ,�
<br /> `'--.� �- � ,r��F' ,�/�;.��;�� :._�r��,�a-�'
<br /> I ��r �� ' REGISTERED Y/ N FEE CURRE� Y/N �
<br /> Address � �c�1,,� �� �JlM/n� ������
<br /> IIIIIIIIIIIIIili111101117111Ilflli6ll� � 1i91111111C7i51#1• oi0190099eo991B9
<br /> RESIDENTIAL Attach (2) Piot Plans; (2)sets of Building Plans; (1)set of Energy Forms; R-O-W Permit for new construction.
<br /> Mfnlmum ten (10)working days after submittal date. Required onsite, Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities &1 dumpster;Site Work Permit for subdivfsions/large proJects
<br /> COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page; (1)set of Energy Forms. R-O-W Permit for new construction.
<br /> Minimum ten (10)�vorl<ing days after submfttal date. Required onsfte, Construction Plans,Stormwater Plans w/Silt Fence.installed,
<br /> Sanitary Facilities&1 dumpster.Site 1Nork Permit for all new projects.All commercial requirements must meet compliance
<br /> SlGN PERMIT Attach (2)sets of Engineered Plans.
<br /> '*"**PROPERlY�SURVEY required for all NEW construction.
<br /> Directions:
<br /> d-6.-8_�_p-�7�i�4�_�����_���-�--Q--6-�A--0--6--9�.g_.8_k�g_8._�_�g�_B--C-�-•�i��A��-�E-��609_p....q-,'�l�-.
<br /> Fill out applicatfon completely '
<br /> Owner�Contractor s(gn back of application, notarized '
<br /> If over$25DD,a Notice of Commencement is required. (A/C upgr.ades over$7500)
<br /> "' Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing'same
<br /> �VER THE COUNTER PERMITTING (copy of oontract required)
<br /> 3eroofs�ffshingles Sewers
<br /> �ervice Upgrades A/C Fences (Plot/Survey/Footage)
<br /> Driveways-Not over Counter if on�ublic roadways..rieeds ROW -
<br /> ,
<br />
|