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<br />813-780-0020 <br /> <br />City of Zephyrhllls Permit Application <br />BUilding Department <br /> <br />Fax-813-780-0021 <br /> <br />Owner's Name <br /> <br /> <br />Date R....lv.d <br />~,,~~..- <br /> <br />JOB ADDRESS <br /> <br />-00'_.'"..''''' r-l ~.. [ L <br />... .- - -. . -.. . ..:=::~:.- 4oo:4iO':83~LD=1 <br />Own.rPhon.Number ~C~~ql().. ~(SlIl,,1 <br />Own.r Phon. Number l1 ()~ - l\ I (r~3lf Vt I <br />- I <br />I <br /> <br />LOT# <br /> <br />y <br />Il\q <br /> <br /> <br />F.. Simpl. TltI.hold.r Addr.ss I n \::L <br /> <br />15 I '5c~ )"11+1 5trfe+ <br />I I PARCELID#/ f\ -~ - Q~ ~000 - IqlcDO ~I 0\0('1 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D ADD/AL T 0 SIGN D MOVE 0 <br />D REPAIR _/ <br />D COMM LA" OTHER I Qp.::) K\t-'nh<:\..O <br />o FRAME 0 STEEL D OTHER I rC (~C'\f <br /> <br />I $\f'l') It r~{()cf.' 1/ 13 p <br /> <br />BUILDING SIZE SO FOOTAGE I I HEIGHT I <br />~~]fi.~~m~~~~~,~~.~..'S!.~';!!.~~~~~~~_~~~~~~~~~~ <br /> <br />L:LI BUILDING 1$ 3;)3lr.00 I VALUATION OF TOTAL CONSTRUCTION <br /> <br />Owner"s Address <br /> <br />F.. Simpl. Titl.hold.r Nam.1 <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />5r <br />o <br />o <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br /> <br />SFR <br /> <br />TYPE OF CONSTRUCTION <br /> <br />BLOCK <br /> <br />DESCRIPTION OFWORK <br /> <br />ELECTRICIAN r <br />SIGNATURE <br /> <br />)$ I <br />1$ I <br />1$ r <br /> <br />o GAS ~ ROOFING 0 SPECIAL TY 0 OTHER ./ <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES 0NO <br /> <br />~~~~-~~.II~~~~JL <br /> <br />:::~:f.., ~!ill I =~~ I ~12!l_~0W <br />Addr.ss ~ _., ---.:._ 81 va I License # I CL- C. 05~ \aLJ <br />~ <br />~ <br />~ <br />---1 <br />~ <br />~ <br />--1 <br />~ <br />~ <br />~ <br />~ <br /> <br />o <br />o <br />o <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />WR_E.C <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />COMPANY <br /> <br />Address <br /> <br />REGISTERED <br /> <br />~ <br /> <br />FEE CURRENT <br /> <br />license # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br /> <br />Lr.L!:U <br /> <br />FEE CURRENT <br /> <br />REGISTERED <br /> <br />Add"'s, <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />license # <br /> <br />COMPANY <br />REGISiERED <br /> <br />Lr.L!:U <br /> <br />FEE CURRENT <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />license # <br /> <br />COMPANY <br /> <br />REGISTERED <br /> <br />~ <br /> <br />FEE CURRENT <br /> <br />Address <br /> <br />OVER THE COUNTER PERMITTING (Front 01 Application Only) <br />Reroofs Sewers Service Upgrades NC <br /> <br />Dnve'vvays <br /> <br /> <br />License # <br /> <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fllm1g <br />Minimum ten (i0) working days after submittal date. Required onsite, Construction Plans, Sanitary FaciHties & 1 d <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after Bubmntal date. Required onsile, Construction Plans, Sanitary Facilities 8 1 <br />All commercial requirements must meet compliance. <br />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />~~:="":"~...i~~~~~~'~~~~'M.~~~-~'&~~~'~~~!if~.itr:-;P:~~':iiG' <br />Directions; <br />Fill out application completely_ <br />Owner & Contractor sign back at application, notarized <br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000' <br /> <br /> <br />.. <br />