|
<br />813-780-0020
<br />
<br />City of Zephyrhil/s Permit Application
<br />Building Department
<br />
<br />Date Received
<br />
<br />
<br />
<br />
<br />Fax-813-780-0021
<br />
<br />*,lkrJf
<br />
<br />Owner's Name
<br />
<br />Owner's Address I 3 1... I q
<br />Fee Simple Titleholder Namel
<br />
<br />She.
<br />
<br />Dr lAW\..
<br />
<br />rJ-o~ .)
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number L
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />I 3g 5 33
<br />I
<br />
<br />C G-.Itv\.. d e. V'\ A v t.
<br />
<br />PARCEL ID#135 - 2.5 - '2-1 - 005A-OOO()() -II 00
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />E3
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />rz c'yvof
<br />
<br />BUILDING SIZE I SQ FOOTAGE I
<br />111111111111111111111111'1111111111111111111111111111111111111111111111'1111111"1"1111111"1111111111111111111"11111111111'11111111'11111111111
<br />
<br />1$ 4 L/ '2>>(w I
<br />
<br />D ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />
<br />D GAS ~ ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />1111111111111111111111111111111111111111111"111111111111111111111111I11111I1111111I111II111111111111111111111111111111111II1111111111111111111111
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />OTHER
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />
<br />DESCRIPTION OF WORK
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />~o~ ./
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMMERCIAL
<br />
<br />License # I
<br />
<br />OTHER I ~ L W- fiL/ I. . COMPANY I St.olf- Bo.. J.. Ma. 1'\ !4of-,$ I /1
<br />SIGNATURE . ~ ~~ REGISTERED I Y / N I FEE CURRENT Y / N I
<br />
<br />Address 12>30 l 0 stt. F; L po (box.f{N License # ICe C a.f--nr 1-1
<br />111111I111111I111111111111I1111I111I111111111111111I1111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111
<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 w/ 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 />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />SIGN PERMIT
<br />
<br />DI~~~ti~~~': ' . . . . , , , . . , , . . . , , . , , , , . . , , . . . , , , . . . . . . . , , . . , . , . , , . , , , . . . . . , , , . . , . . , . . , . , , . . , . . , . . . , , . , . . . , . , . , . , . , . , , . , , . , . . , , , . , , . . , , . , . . , . . , . , . . . . . . .
<br />
<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)
<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 AlC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|