07-6357 - Laserfiche WebLink

Browse Search

813-780-0020 City of Zephyrhllls Permit Application Building Department raX-DI .)-/ DUUU.I: I OWner'. Nam€. -11-07 l/. OWner'. Addn 55 I '-I C) S-I /9 I"- Fee Simple Tr; '.holder Namel Fee Simple TIl:eholder Address I 11'1 S' J / 9' 1M I fa S-I ' 2e~ '1//';/)5" Ft I '3 s S"9;;l- s-o?d11 Owner Phone Number g J .3 - 7 51 ~- Sd / OWner Phone Number I OWner phone Number I Date Received ,11111111111111 t f-r 2';>,IIJ'I'--;:)//S .-c/, S,"?S-'-/a7- S-:z.OCJ I LOTti I j pARCEL /0.1 p/~ ~l, ~d..)-OOIO ~ ()O~CO -0010 (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D JOB AODRES~ WORK PROPOSED NEW CONSTR INSTALL SFR BLOCK I B o D ADD/AL T REPAIR COMM FRAME D o o DEMcLlSH SUBDIVISION El PROPOSED USE 0 TYPE OF Cot~STRUCTION 0 DESCRIPTlOII OF WORK I e.. e. f' () (:)+:" I II........ I" II....... I......... 1.1" III......... I~..I............. 1................,.........'.1....1........ I'" I~' I-I.......... I-I.. I . ~........ D BUILDING 1$ .'31, /17 0 '3ll1.~O VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL 1$ I D PLUMBING 1$ I D MECHANICAL 1$ I o GAS 0 ROOFING D SPECIALTY 0 OTHER , ' FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 111'1'1"'" 11'11"""""'" I" II" I I I I I" I I" Ill" I I I'" I I I,: I" I" I. I"" "1""'" 1'11'1 I I' I I I I'" I'" 1'1 1'1 I I I" I I" I'" II"" f;: 11'1'" I" OTHER I STEEL 0 OTHi2:11 f{. ~ L- t" .. ~J ~ BUILDING SI~E ($fa HEIGHT I / .sk~ S ~'FOOTAGE I AMP SERVICE D PROGRESS H!ERGY D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION 00~ BUILDER I SIGNATURE, COMPANY REGISTERED I I I I I I I I I nrJ PLUMBER SIGNATURE V/ N FEE CURRENT License # YI N FEE CURR::t1T License # 1\ YI N FEE CURRENT Ucense # Y/N FEE CURRENT License # V/N Address ',n .~'l: COMPANY REGISTERED ELECTRICIAN SIGNATURE Y/N Address COMPANY REGISTERED Y/N Address COMPANY REGISTERED MECHANICAL SIGNATURE V/N Address OTHER /~-_. ' COMPANY I g~ f ;2~~ l/w9 SIGNATURE .-t-- ' .)' REGISTERED /I l Y I N I FEE CURRENT ....... I~q W. ~CSG~ ~'~, ~roiJesu\JJ€-"- i\{Co~ J L1ceilse# I 1111111111111111 11111 III Ii' 1111111 III ,I I III Him J In... ... . . . .. .. .. ...... ~.u ~M' I RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-Q-W Permit for new construction, Minimum ten (10) working days after submittal date, Required onslte, Construction Plans, Stormwater Plans wI Slit Fence Installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlslonsllarge projects Attach (3) sets of Building Plans; (1) set of Energy Forms. R-Q-W Permit for new construction. ' Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans w/ Slit Fence Installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance Attach (2) sets of Engineered Plans. .....PROPERTY SURVEY required for all NEW construction. 111111111111111111111111111111111111111111111111111111111111 I 11111 i 111111111111111111111111 i i 111111111111111111111 II i 1111111111 i III Ii II i 11IIIII1II DIrections: Fill out application completely. Owner & Contractor sign back of application. notarized If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) .. Agent (for the contractor) or Power of Attomey (for the owner) would be someOne with notarized letter from owner authorizing same OVER THE, COUNTER PERMmlNG (Front of Application Only) ReroofS Sewers Service Upgrades Ale Y/N COMMERCIAL SIGN PERMIT Fences (Plot/Survey/Footage) Drlvew~ys-Not over Counter If on public roadways..needs ROW