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813-780-0020 'City of Zephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received S P 4q j phone Contact'for Permitting° Z l l J V�� <br /> Owner's Name {' o L!S� Owner Phone Number <br /> Owner's Address . �`Z S °�G 4�U�� ✓jT V Owner Phone Number <br /> _e <br /> Fee Simple;Titieholder Name- Owner Phone Number <br /> Fee Simpleilitleholder Address G <br /> JOB ADDRESS -7G►�� LOT# <br /> SUBDIVISION PARCEL-ID#. 03 Er-_Z/--017 C) C.)I�Z1 <br /> (OBTAINED FROM PROPERTY.TAX NOTICEI <br /> WORK PROPOSED NEW CONSTR ADD/ALT = SIGN 0 = DEMOLISH <br /> 8 INSTALL a REPAIR <br /> PROPOSED USE _ SFR -COMM 0 OTHER <br /> TYPE':OF CONSTRICTION Q 'BLOCK = FRAME 0. STEEL 0 <br /> DESCRIPTION'OF WORK <br /> 4 <br /> BUILDIWG'SIZE SQ FOOTAGE HEIGHT <br /> =BUILDING. $ VALUATION'OF TOTAL CONSTRUCTION <br /> i <br /> ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C. <br /> =PLUMBING: $ <br /> MECHANICAL $ q VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Qv ROOFING Q SPECIALTY. 0 OTHER <br /> - <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> i <br /> :.BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> .'`:'ELECTRIC..IAN. COMPANY_ <br /> SIGNATURE REGISTERED Y/ N • FEE CURREN <br /> Address License#, <br /> PLUMBER.. 'COMPANY:• . <br /> SIGNATURE ' REGISTERED Y/ N: FEE CURREI. • <br /> Address ` Llcerise#; <br /> MECHANICAE — OMPANY. e('rc1�.�vte-9 •e� <br /> `:`'- SIGNATURE"'' � "'`� REGISTERED Y/ N FEE C E� Y/ <br /> AddPess.r..., t ... V ti Licensee.# <br /> OTHER:: ::.,:,;..: .. COMPANY <br /> SIGNATURE;S;t;; : ,*. .:;. . _ REGISTERED Y/.N FEE CURREK <br /> Address.; License# <br /> aItESIDENTIAI:z., Attacli.`'4 1?Iot P.,lans 2=sets ofi;Bulldin .Plans'1 sef`of Ener Forms R=O Permit 'r new,constiuction <br /> 4Miriimum<ten 10.' Orkin"`da s'aftersubrtiittaldate::.'F2e u"ired':onsite'Constrlction'Plans StocmwaterPla 'sw)SiltFenceinsfalled <br /> :.. <br /> Sanitary;Facllities:8�.l.dumpster;,Sife;:Work Permit forsubdivlsionslla;rge=:projects":... ' <br /> r COWIMERCIAL Attach(2)'complete°sets of`Biiilding`Plans'pliis a Life'Safety'Page;(1)set of Energy Fonns.R-O-W Permit for'new constructlon. <br /> Minimum 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 fog all new,profe6ts.All commercial requirements must meet compliance <br /> '',=$IGN PERIWIT -Attach(2)'FiiR,,of,EngineerediPlans:.11- , <br /> h: ****PROPERTY SURVEY.required,for,alL NEW construction._. <br /> rr, <br /> Directions:` <br /> Fill out�8pplioation completely. <br /> 'Qwnerj8 Contractor sign�back.of application,notarized <br /> If over:$2500;.a Not ice.of:Commencement is required. (A/C upgrades over$7500) <br /> Agent'(fo�lftie'.contMdtor)*or�Power•of•Aftomey(for�the owner)would tie someone with notarized letter from owner authorizing same <br /> OVER;THE COUNTER:PERi tTI T.IRQ., _(copy of-contract,required) <br /> N:yRorpofs if hIngles Sewers Service Upgrades'-A/C` Fences(Plot/Survey/Footage) <br /> .Driveways-Not over Counter if on public%aluvays:needs ROW 4 Y <br />