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8'13-780-0020 City of Zephyrl�ills Permit Application Fax-813-780-0021
<br /> • Building Department.
<br /> Date Received ������,����e��� �, �,_, ��y G��, d,¢��'��a�y
<br /> �-r-�--�-r-�--�_ Phone Contact for Permitting __
<br /> r
<br /> Owner's Name �, � �;- a � � Owner Phone Number � .�L�G�'. � �,?�, �
<br /> Owner's Address ��������� �� �rs--� ,� �� '`�'2') '
<br /> , � T�'��i'°��J� � / Owner Phone Number
<br /> ' -
<br /> Fee Simple Titleholder Name ` �r�. �� Owner Phone NumLier
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ��C I Z � ���� - � y/�C�� V ' ,� �
<br /> v , � � �-.���� LOT# -// .
<br /> SUBDIVISION J �i 1 L�'Gr'G �� PARCEL ID# �> ''�-f.�' ,'���-� � J.-L�'� ��--��(,�
<br /> e� (OBTAINED FROM PRbPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR e ADD/ALT �� 51GN � � DEMOLISH
<br /> ' 'INSTALL REPAIR
<br /> PROPOSED USE �f SFR � COMM � OTHER
<br /> TYPE OF CO.NSTRUCTION ��' BLOCK .
<br /> 0 FRAME � STEEL �
<br /> DESCRIPTION OF WOqf( O`��t'� ���/�(.c•�'�ry�) � ,�Se.� � p� I
<br /> ��,�zr � � 1 n
<br /> �J C c. J ���:'1-I-1/� .���-Y,�.
<br /> BUILDING SIZE SQ FOOTAGE ��� '
<br /> HEIGHT
<br /> "�-r-rr-T-�-rre-�-r-T-r-�r-�-r-r-r-P-o--t-_r-Q�--rp'-r--r-o-e-r-e-n--�--rrrvp--r-s-re��-P-y--r-rr�-o--e-Q-�-o--u-ra-e-�-Q-a�-
<br /> `�BUILDING �
<br /> � I�. �r,;=t; VALUATION OF TOTAL CONSTRUCTION
<br /> � i .
<br /> �ELECTRICAL $ .- AMP SERVICE
<br /> �,� �� � 0 PROGRESS ENERGY � W R.E.C.
<br /> �PLUMBING � s �
<br /> � - �')
<br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> ��,��: -�f � 3 ��
<br /> �GAS �� ROOFING � SPECIALTY � OTHER '
<br /> FINISHED FLOOR ELEVATIONS '
<br /> j�� C�,��r FLOOD ZONE AREA �YES NO
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<br /> --F--C-4--G--0-F--k�-F-F-�F-�6-F�-0-8-{--Q-i-7-�-&-C--6--9-C�--9--G--C-v-F-�-G-9--�-t " �-
<br /> �—a—�--9--�--a—a—s�,—a—o—:—e--z—�aaa�—r-a—.9.—e—a—e..,e�
<br /> BUILDER
<br /> SIGNATURE � � -''� COMPANY �.. � _ �-, ���-�.,,,.-� �"J,L�
<br /> REGISTEFIED Y/ N FEE CURREA Y/N
<br /> Address ����v� /_��<C�.ry7 .[� r^ lGia� c.. '
<br /> � License# ���G��'�� � ;�
<br /> �LECTRICIA�V' �� ,�/�'' COMPANY � ��'• � ��- -�
<br /> SIGNATURE �''"z'�'�'' �`� G' ,l?�C�n 7,.�",�',,�p � 'r'°4; ,�,� �:
<br /> , RE�ISTEFIED Y/ N F.EE CURRE� Y/N
<br /> Address � 4°�.�y QJ��'�,p�',/'`�E'i' �� � � �,f License# (,�. �``
<br /> , ��.�Q�<:J ���
<br /> PLUMBER ,� p / � �
<br /> SIGNATURE � �""��..__�— COMPANY � ��..�'"�M.7.�` •.�A',�•G'�,��:�-,i�..�u �,��AJ'r�,F�,�
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address f f��� mrl,r''na�(�'cr `ir��.���,� T°^,.: F_
<br /> ' `—� `" License# ��k�'�' � ,,/r�. ��
<br /> MECHANICAL -� ,
<br /> �^a' �:.'.,..-:^G../ COMPANY �A~��,.i}��'"�,l`��Al�' r � ��e�.?.JJ"�
<br /> SIGNA7URE � . �m� , �i ",�'- � ., �,
<br /> �RE�ISTERED Y�'/ N FEE CURREA Y/N
<br /> Address ���-7� ��-�'"��.� �x� f'e�c�n,..a��,,�x'J',.�� , '
<br /> j License�# ��i������� �'
<br /> OTHER '
<br /> SIGNATURE � �... ,--..-.. .- COMPANY 1.`aA�����,�1�,�.��,/.�/?�;=,.� �
<br /> � REGISTERED Y/ N � . ����� �
<br /> p �- FEE CURRE� Y/N �`
<br /> Address I��,��.7,,�/�r�3 rG,� 1 , � � ,cJ�r,-... �
<br /> � `�"�" �7� ' �'� License#
<br /> IIIIIIIIIIIIIi1111110111L11111i111aaL911011111111L .pp10l09009lpaplp0
<br /> RESIDENTIAL Attach (2) Plot Plans; (2)sets of Building Plans; (1)set bf Energy Forms; R-O-W Permit.for new construction,
<br /> Minimum ten (10)working days after submittal date. Required onsite,Construction Pians,Stormwater Plans w/Siit Fence installed,
<br /> Sanitary Facilities&1 dumpster;Site Work�Permit for subdivfsfons/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 /> Mlnimum ten (70)wor!<ing days after submittal date. Required onsite, Construction Plans,Stormwater Pians w/Silt Fence installe.d, :
<br /> Sanitary Facilities &1 dumpster Site Vliork Permit for all new proJects.All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach (2)sets of Engineered Plans. �
<br /> ''***PROPER7Y•SURVEY required for all NEW construction.
<br /> Directions:
<br /> Ffl�l o�ut appllcat��om�te���--�o-L,1-.p_.o_p--6-�_��e-��6-�-8-�-9-A_s�e`9--&--�c-�-.B-4-�.¢�-9-p�-fimp�-9_@�9.�a-�..tt-�-.
<br /> Owner�Contractor sfgn back of application, notarized
<br /> If over$25D0,a Notice of Commencement is required. (A/C upgrades over$7500)
<br /> "` Agent(for tfie contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
<br /> �VER THE COUNTER PEAMI7TING •
<br /> �eroofs If shingles Sewers (copy of contract required)
<br /> :Service Upgrades A/C Fences (Plot/Survey/Footage) _ �
<br /> Driveways-Not over Counter if on;�ublic roadways,.needs ROW � , � -
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