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.13-780-0020 Gity of Zephyrhiiis Permit Application Fax-813-7e0-0021
<br /> Building Department
<br /> Date Received . _=,.;.Phone'ContacfforPerraittin
<br /> ;.:
<br /> Owner's oaame :L S 4 Owner Phone Number
<br /> Owner's Ajtdress 77
<br /> / Owner Phone Number-•
<br /> Fee Simple Titleholder Name _T� O*neePhone Number
<br /> Fee Simple Titleholder address
<br /> 1. 1:
<br /> JOB ADDRESS � c� � �` l ,d t d-* LOT#
<br /> SUBQIVISION PARCEL•1D#,
<br /> (OBTAINED.FROM PROPERTY NOTICE)
<br /> WORK PI2C)P...OSED NEW.CONSTR ADWALT [ S1GW Q Q DEMOLISH �.
<br /> ' INSTALL 8. REFrAIR
<br /> EJ
<br /> PROPOSED;:USE• SFR 0. COMM [�' OTHER
<br /> TYPE OF CONSTRUCTION: ``: BLOCK ([ FRAME. 0., STEEL _[�;
<br /> 7`DESCRIPTION"OF WORK
<br /> -BUILDING AIZE SQ ROOTAGE '. HEIGHT
<br /> F-(BUILDING $
<br /> j 00 VALUATION'OF TOTAL,CONSTRUCTION'
<br /> 4•
<br /> 0 ;=ELECTRICAL $ . AMP SERV.iCE PROGRESS ENERGY W.R.E.C.=PLUMBING $
<br /> j
<br /> =141ECHANlCAL $ VALUAl`ION OF MECHANICAL INSTALLATION ,x
<br /> ;GAS C]: ROOFING Q, SPECIALTY., OTHER'
<br /> FINISHED',,FL60R ELEVATIONS FLOOD ZONE AREA =Y.ES
<br /> NO I
<br /> f
<br /> BUILDER; '� ( COMPANY.
<br /> SIGNATURE REGISTERED Y-/ N FEE CURREP
<br /> �-~�-
<br /> I'
<br /> Address, . 'License
<br /> t
<br /> ELEC.TItIGiAN. COMPANY':
<br /> SIGNATUi1 E REGISTERED Y/ N FEEURRREEA
<br /> Address . License#-
<br /> ' .:P.CU.MBER '. COft
<br /> GNAPANY
<br /> SITURE:` REGISTERED YT.Nr FEE-GURREN.
<br /> i.` Address -
<br /> i
<br /> ''.License#;
<br /> .;.t MECffANiCAL
<br /> u�t'SIGNATURE - RsGis7eRE D Y/.N FEE:cuRREn.
<br /> License.# .
<br /> 'COIUEAANY
<br /> SIOP1►TUR i i T`r REGISTERED Y RREA'
<br /> g: FEE•CU. Y/N
<br /> a,r� Address. • .� ,z� �:,'<�:. •License•#
<br /> . .,_r.;_•�, .,�....a, �. .... ... :....:.•.�.:r::,oi:> .. .?'- - `•'w;zw,:i'`:.»;r_:,;:.'i:::'�.:._ _
<br /> mRESID.ENTiAi:: ttaEh;{2)$Pto#:Pians�:( jesetsraf.Buiicling Rlans,.(1}.�et of Energy F6 t,R-O t�V P.ettnit or:new canstiuctlori�;,
<br /> 1.. .,.r..h;;'.:'i,. .u,•• _ .•.'F,a.jz_. : "..£._-.4,,.,.....y: pn•,c j.F:' ,C.y {'1!.[ ..v; , SIIt.Fenc
<br /> x _
<br /> 1:= ~. °�;_• rfllinimu ;.etem TO;i�vojk n'fla `after•sut rriittai date.:.:Requlred ansite;Gon§tni'gtion Plans,:Stopnwater'Plans w/ e:installed; '
<br /> Sancta, 5Facllltiestslum ste. 4VVorle Permit=forssrbdivisions a 'e; fo acts
<br /> MMERCIAL Attach(2�=i�mp(ete sets of`Builitin Pisns plus`a Cife Safety Page;(1)set of Energy Forms.VR-O W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence.installed,,.
<br /> ry ' l=new=projects.Aitcommercial requirements mustmeatrampilance
<br /> Sanitary,Facilities&-1 dum star.Site Work Petmit fot al
<br /> I',S1.�IY�PERili1(T 'Attach'(�)setscif�Engrae�reclPlaiis.,, ...,�,.c. . ........... .. . ..•:
<br /> ""PROPERTY SURVFY required„)or,eU.NEW.construction....
<br /> Ss l<auto'
<br /> pllcation.completely.
<br /> OvunerB-Contractor slgn:back of application,notarized
<br /> If:pver:$2500;_a Notice',oft. rnmencement'.Is required. (A/C upgrades over$7500)
<br /> •• A ant'.for the can g - ( '+` �'tractar.}�,orPowerrof'Attomey�(fdr-'the'owner)"would be someone with notarized letter from owner authorizing same
<br /> OV.ER7TifE COUN ER P Ri,I, �iPIG`,<:w__;(copy:afacontcaattiregwtred)
<br /> sRergofs:ifatrin'o bs Sewers. :Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Iklveways-Not over Counter if on pubiic''roadways h eds'ROUV "
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