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B13780.0020 City of Zephyrhilis Permit Application Fax-813-78D-M21 <br /> Building Department Date Received Phone Contact for Permitting r6ci-_C[� <br /> o u:5 <br /> Owner's Name "• Owner Phone Number <br /> Owners Address • Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address [ �� <br /> L 3�Li�Y_J 1 <br /> JOB ADDRESS Lnsin � � LOT# - <br /> SUBDMSION d PARCEL IDS <br /> (OarAIMED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW C.CNSTR 8 ADD/ALT = SIGN DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 Comm = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK <br /> ^—�= FRAME u STEEL = <br /> DESCRIPTION OF WORK ew —fit ` r 1 <br /> BUILDING SIZE 1 7 SO FOOTAGE= HEIGHT <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = WR.E.C. <br /> E12PLUMBING $irsickS <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �j <br /> =GAS = ROOFING O SPECIALTY= OTHER v PA <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/N FEECURREI, <br /> Address I Ucense# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I YIN FEECURREI, I Y/N� <br /> Address License# <br /> PLUMBER COMPANY tti�CCAA— h Z0 G-(a�+^� <br /> SIGNATURE REGISTERED N FEECURRV, I Y! <br /> Address License#S— 1 kc a O <br /> MECHANICAL COMPANY <br /> SIGNATURE I Y/N FEECURIM I Y I'M <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURREn Y 1 N <br /> Address License tk <br /> I11111111111111111111111111111111111111111111illllllllllllllllllfll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for newconstruction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stonnwater Plans w/Sift 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-0-W Permit for new construction. <br /> Minimum ten(10)working days after submittal deto, Required onsite,Construction Plans,Stormiwater Plans w/SOt 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 /> • 1E• • 1..1 ' • il.l�l • I�U1/.• • 1 • Li.f ll.l • 6... . <br /> DrrectIons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If ovor$8500,a Notieo of Commoncoment 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 Sewers Service Upgrades A/C Fences(PloUSurvey/Footage) <br /> Driveways-Not over Counter If on public roadways..needs ROW <br />