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813-780-0020 City of Zephyrhilis Permit j kpplication Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permitting — <br /> Owner's Name 15 h0 Z•Z.() O ner Phone Number <br /> Owner's Address V,(Jyl WQAP nor Phone Number <br /> Fee Simplelitleholder Name P O er Phone Number <br /> Fee Slmpli�Titleholder Address <br /> I nn <br /> JOB ADDRESS a% 3 L- �1_rn n via o U LOT# <br /> SUBDIVISION r'.T'(V-)OQa ' 21-lA<0S PARCEL ID# O —� ' oa L� Od 3C� <br /> d S (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR= ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER . <br /> TYPE'OF CONSTRUCTION BLOCK 0 FRAME. = STEEL <br /> DESCRIPTION OF WORK <br /> BOIL"DING SIZE F SID FOOTAGE HEIGHT - <br /> -•3 <br /> =BUILDING $ VALUATION'OF TOTAL CON TRUCTION <br /> =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY Q W.R.E.C. <br /> =PtLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICA INSTALLATION <br /> i <br /> =GAS = ROOFING SPECIALTY = THER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> } <br /> •'BUILDER COMPANY <br /> SIGNATURE REGISTERED LE Y'/ N j FEE CURREN LKLN <br /> Address -License# <br /> T.-:ELECTRI,GIAN •,. COMPANY <br /> SIGNATURk REGISTERED Y/ N FEE CURREN. <br /> Address' - License# <br /> PLUMBER y: COMPANY SIGNATURE. REGISTERED LT_Y/'N: FEE CURREN Y/N <br /> f, <br /> Address. 'License# <br /> MECHANIC _-COMPANY, ..` <br /> SIGNATURE" REGISTERED Y_L N . - .FEE,CURREN Y/N <br /> Address'== License.#. <br /> :.OTHER:; }: : ;, COMPANY ' <br /> sIGNATUREa..;:.��. .t Scott Blackman Roofing, Inc ' REGISTERED N FEE CURREN L <br /> Address,':.,; License# GGC C)S /S <br /> RESIDENTIi4L°,„;'_Attach'(2)P1 P.lar s'(2)=sets of d Iding'Plaris;A(1)`set of Energy_Forrris R,O.=W Perrriit,for new.construction, <br /> Mlnimum ten(10)uvorking,days'.after submittal date.>Required onslte;Con truction Plans Stormvirater Plans w/Silt Fence.installed,. <br /> Sanitary Facllities;8;l,:dumpste�;;Site;Work_ Permit forsutid'ivislons/largep� jests': <br /> :;COMMERCIAL Attach`'2'`com"lets"sets of'Buiidin'Plaris lus a�lJfe Safe Pa e; 1 set Energy Forms.R-O-W Permitfornew construction. <br /> ( ) P 9 P tY 9 ( ) 9Y <br /> Minimum ten(10)working days after submittal date. Required onsite,Con truction Plans,Stormwater Plans w/Silt Fence installed, . <br /> Sanitary Facilities&1 dumpster.,Site Work Permit for'%all•new projects.All mmercial requirements_must meet compliance <br /> .$IGN PERMIT Attach'(2)'sets;o;Eogneered.Plans. <br /> ......' ....PROPERTY_SURVEY,required.for.all.NEW construction. _ <br /> ' <br /> <Directtons: <br /> Fill out;application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500.a Notice.of'Commencement is required. (A/C upgrades over$7500) <br /> Agent,(for th'e°con btor)'or'Power of Attorney(for'the owner)would be someone with no rized letter from owner authorizing same <br /> t;`.-MER3HE 000NTER_PERMITTING.. ...-. ..(copy_of-contract•required) <br /> ,R'eroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footag ) <br /> Driveways=Not over Counter if oh public'roadways..needs ROW <br />