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813-780.0020 City of Zephyrhilis Permit Application Fox-813-780-0021 <br /> BuiidIng.Department <br /> Date Received Phone Contact for Parmit"na, 3 -- <br /> 5 <br /> Owner's Name , Owner Phone Number <br /> Owner's address -Q_ owner Phone Number <br /> Pao Sine rla Titleholder Man,e olxner Phone Number <br /> Fee Sipple Titleholder Address dC88�i133 55 V '-0-- ,LOYi <br /> SUDDIVISIOit1 / {�.,. S f�dRClrL IbrJ <br /> (.0STTAIMEtl:FRCANWPR0PE9TV TAX@lF}TICEIr <br /> WORK PROPOSED ElNEW CONSTR ADD/ALT � SIGN ® ® DEMOLISH <br /> INSTALL LnJ REPAIR <br /> PROPOSED USE 0 SFR Comm OTHER <br /> TYPE OF CONSTRUCTION � BLOCK FRAME STEEL [� <br /> OESCRIPTIOW OF truORK '1 <br /> TaLt3.i3:ilG 34a,E SO FOOiAGe.NiE4 <br /> =BUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> ,=ELECTRICAL $ AMP SERVICE PROGRES,S.ENERGY W.R.E.C:: <br /> =PLUMBING r <br /> L <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING ® SPECIALTY OTHER <br /> FINISHED FLOOR ELEVAS'fONS FLOOD ZONE AREA [ YES NO <br /> „_..,,—,°r,,..,.�^«.�1-.M.4....I�y_,,,�,.�...--..R.-,. �. pp 4.... a,,,n u—n...-n__p n..• n n •_..�n._..�...�L�._...,__Q.� <br /> BUILDER - COMPANY .A41 ZSi 1 <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/ <br /> Address (`� 1J'' License l C -S-t q 9 <br /> ELECTRICIAN CL}MAANY <br /> SIGNATURE REGISTERE Frr CUMWI, <br /> Address License l0 .--.. <br /> PLUMDER COMPANY <br /> SIGNATURE REGISTERED Y/ N J FEE CU(RRRR`E'K — Y/N <br /> Adldireasz L1censel <br /> MECHANICAL COMPANY 6• <br /> SIGNATURE REGISTERED Y/ N , FEE CURREN <br /> Address �; License 4 �....,.�..:.�.®d. � <br /> OTHER COMPANY <br /> SIGNATURE E REGISTERED Y/ N J FEE CURREN Y/N <br /> -Ad iresS - --- - — LicenseV <br /> (i89Q � fIog09 ! ll4HIIBi18 -B919B9 ! ! ! ! 1! H ! HlIHDHIDflH98HH8lHH9lH ! lGHIOHHlH9i0H <br /> RESIDENTIAL Attach{2yPlot Plaits;(2)sets of Building Plans;,(1)set of Energy Forms;,R-Or-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 /> -Sanitary Facilities&1 dumpster;Site Work Permit for subdivislons/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 tan(10)working days after submittal date.,Required onsite,Construction Plans,Stormwater Plans w/.Slit Fend;a installed, <br /> Sanitary Facilities&i dumpster.Site Work Permit f6r all new projects.All commercial requirements must meet compliance <br /> SIGN PER1611T Attach(2)sets of-Engineered Plans. <br /> —'PROPERTY SURVEY-required for aii;NEW construction. <br /> Directions: <br /> Fill out application cornpletaly- <br /> Owner&Contractor sign rack or application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7600) <br /> °* Agent(for the contractor)or Power of Attorney(for the owner)would.be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Remofs if shingles Sewer Service Upgrades A/C Fences(Plot/Survey/Footago) <br /> l3viv©�aoyci-P101 over count®?A on"Iovm 4p@rCwey4..i J 5��0.4 <br />