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<br />813-780-0020 <br /> <br />City of Zephyrhllls Permit Application <br />BUilding Department <br /> <br />Fax-813-780-Q(l21 <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I 3;fS33 <br />I Oak Th~ <br />B <br />D <br /> <br />TYPE OF CONSTRUCTION D <br /> <br />I <br /> <br />PhoneContacttorPermillina r--l ~D-- [ L.. .".._. <br /> <br />.--.- . --,.-. '-'-~~:=::-;Ti;'3 - '7S'"i~~- (i~;9~1 <br /> <br /> <br />Ownsr Phone Number I I <br /> <br />Owner Phone Number 1 1 <br /> <br />I <br />,,1~tJ-~ I LOTn [ I <br />PARCELlDnl OJ. -.J-b ~J./ - 0050- 00000-0110 I <br />(OBTAJNED FROM PROPERTY TAX NOTICE) <br /> <br />I <br />B <br />CJ <br />CJ <br /> <br />ADD/AL T D SIGN D MOVE D DEMOLISH <br />REPAIR 7Z.. I <br />COMM D OTHER I .(l! -r<-Oo/ <br />FRAME D STEEL D OTHERA <br /> <br />Owner'. Addres. <br /> <br />Fee Simple Titleholder Name I <br /> <br /> <br />Date RllCelved <br />~~.'...' <br /> <br />Owner, Name <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />PROPOSED USE <br /> <br />SFR <br /> <br />BLOCK <br /> <br />DESCRIPTION OF WORK <br /> <br />50 FOOTAGE I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />~~~.:ii~~~~~~..':':.::':':=~:~~.~~~~~~~~-~~~~~~-~~: <br /> <br />D BUILDING 1$ if 0 tW f VALUATION OF TOTAL CONSTRUCTION <br /> .70 , <br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ l VALUA TlON OF MECHANICAL INST ALLA TlON <br />D GAS D ROOFING CJ SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />_~__~_Jt.~_~..~..w <br /> <br />COMPANY <br /> <br />~~~:~ ~/ c~d, <br /> <br />License # kr -c 0 s-g I 3' t/ I <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />I <br /> <br />~ <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />Address <br /> <br />ELECTRICIAN [ <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />license # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Lr.L.!U <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />Addr.., <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Add ress I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />I <br /> <br />License # <br /> <br />COMPANY <br />REGIS7ERED <br /> <br />~ <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />~ <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />~~~:~~~~~~'1t~~'@Jo:::Fli--~,.~~.ti!~.~~~,~~mP~,:m~F;;;;f'~'i!.:iiG--;P:':;';~~::a;~~EJ~;o.,:~:m-:1i: <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If oyer $2500, a Notice of Commencement is required, (AlC upgrades over S5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades NC <br /> <br />Driveways <br /> <br />Fences (PloVSurvey/Footage) <br />