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8i3-780-0020 City of Zephyrhi)is Permit Application Fax-813-780.0021 <br /> Building Department c� <br /> Date Received Phone Contact for Permittingg ) — <br /> TTTi i TT'I"' i'TT"i T <br /> Owners Name mkc-IL L,CL Owner Phone Number <br /> Owners Address a v <br /> f ^ i . 2g O�}(���fF Owner Phone Number <br /> � `' <br /> Fee Simple Titleholder Name !_�T f Owner Phone Number <br /> Fee Simple Titleholder Address 1 <br /> JOB ADDRESS WINS q L 1 LOT 0 <br /> SUBDIVISION ( Q.�S PARCELfDO ����lilt" <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT = SIGN = = DEMOLISH <br /> EV INSTALL REPAIR <br /> PROPOSED USE = SFR = COMM L_� OTHER <br /> TYPE OF CONSTRUCTION = BLOCK { FRAME = STEEL = <br /> DESCRIPTION OF WORK 1 Y1 \ C(� <br /> BUILDING SIZE 'IQ)X 9 SO FOOTAGE® HEIGHT <br /> BUILDING S 14 VALUATION OF TOTAL CONSTRUCTION <br /> j" ELECTRICAL S&C)o _ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING S 9 <br /> =MECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY W10.V 1 I eS <br /> SIGNATURE t REGISTERED I Y N FEE CU(RREEP Y/N <br /> Address h 335 License# i Cofr_ 0_310105 t J <br /> ELECTRIC f COMPANY e L+12-t C <br /> SIGNATURE REGISTERED 1(yJ N FEE CURREA I YIN <br /> Address a License#I ec F-300 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CURREA Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGLMRE0 YIN FEE CURREn LXLN <br /> Address License# <br /> OTHER 1 COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURRF7. LXLN <br /> Address License# <br /> 1111111111II111i1t11i11i1111111111111111111111111111111111111111161 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-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 /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/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)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> —PROPERTY SURVEY required for all NEW construction. <br /> . . . . . . . . . . . . <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> if over$2500,a Notice of Commencement is required. (AfC upgrades 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 /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Surrey/Footage) <br /> Driveways-Nat over Counter if on public roadways needs ROW <br />