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<br />h"1I P 't Art Fax-813-780-0021
<br />813-780-0020 n~ City of Zephyr I S erml pp I~a ion -r :.... -, _::}. ,CS '-\ 20(0 \>0..'\
<br />\' Building Department ( ,.,' \ \ -" ':7- I
<br />7 d7 - L/ L( 1-{ - d,cl g d...
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<br />Date Received
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<br />s-~-o
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />Fee Simple Titleholder Name
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<br />l-L-L
<br />~~ad ,\, R&:f\ 730
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Address I
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<br />5~ ~ I
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<br />GAU
<br />I
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<br />r:s:::I ADD/ALT 0
<br />D REPAIR
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<br />D COMM 0
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<br />D FRAME 0
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<br />DESCRIPTION OF WORK I~ e..f'Y\ 0(".) ~ L ~ U \"\ <::0 Q;'1
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<br />I I SQFOOTAGE I \ ~ ~C)
<br />TTfTTII , , . , II , , . III . , , III , 111I , III , 1111I1 , 11II1 , . 11I1IIIIII . III , III1 , . . I1IIIII1 , , . I , I . III111III . III . III1 , , . III r I III , III , III , I 11111111I , 1I1111I rill
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<br />JOB ADDRESS
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<br />o} vJ
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<br />LOT #
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<br />WORK PROPOSED
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />PARCELID#I \ (). 2t.v . 2- \ _ 0020 - ou(X.D. OU3 D
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />SUBDIVISION
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />El
<br />o
<br />o
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<br />DEMOLISH
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<br />BUILDING SIZE
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<br />- New ~I eJ.
<br />r
<br />HEIGHT I
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<br />PI0f\o\b
<br />I
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<br />I
<br />I
<br />~I
<br />
<br />OTHER
<br />STEEL
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<br />I
<br />D
<br />
<br />OTHER I
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<br />.s c.S ~
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<br />1$ Q IS:)(~ I
<br />~ ELECTRICAL 1$ :2): 5 (:) 0 I AMP SERVICE D PROGRESS ENERGY DC c:. ::c.
<br />~ PLUMBING 1$ I -- ,90.0-0
<br />I () GO 0 __ ,90. OD - (.( Al!-.
<br />,
<br />~ MECHANICAL 1$ I 5 (') 0 I VALUATION OF MECHANICAL INSTALLATION O~tY:>~ '-
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<br />~ GAS D ROOFING D SPECIALTY 0 OTHER f7n'""l - rl ~N\.I..":) 3/:za
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO
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<br />~
<br />
<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />BUILDER
<br />SIGNATURE
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<br />fl~~
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<br />COMPANY
<br />REGISTERED
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<br />License # leG C Do'6911L I
<br />(. If:L+t- ic 0 f 9.PQ/f;M.
<br />FEE CURRENT I Y I N r
<br />License # I ~c., OOa g. S s -U
<br />y ~ /;1" (f? ~I ;t2 t""'C .
<br />N Y/N
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<br />Address
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<br />ELECTRICIAN I H fi? ..p
<br />SIGNATURE / ./ L. 4~
<br />Address I
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<br />:~::r~~E W ~.le I1r-L-
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<br />
<br />Address I
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<br />MECHANICAL ~~~/'0--
<br />SIGNATURE =~"-\vL.
<br />Address
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<br />~~":TURE l/j ~ je ~
<br />
<br />
<br />Address I License # jc.r~ () )-7 I 77
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<br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111
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<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans. Stormwater Plans wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction.
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />L'}.f-\.c,
<br />Y I N I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />FEE CURRENT
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />DI~~~ii~~~': . . , . , , . . . . , . . . , . . . , . , . . , , , . . . , , . . . . . . , . . , . , , . . . . , . , , , , . . . . . . . . , , . , , . . . , , . . . , , , . . , . . . , . . . . , . . . . . . . . . . . . , , . . . . . . . , . . , . . . . . . . . . , , , . , , . . . . .
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<br />Fill out application completely.
<br />Owner & Contractor sign back of application, notarized
<br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000)
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<br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
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<br />OVER THE COUNTER PE~MITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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