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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 /> <br />Date Received <br />..""".......-.~.. <br /> <br />Ow"er's Name <br /> <br />~~ f?,6, '" <br />/VIi n:h G..n +v I J1~ e I .--M: <br />I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />I <br />I <br />I <br />LOT# lo4o I <br />'-IOOCD ctWol <br /> <br />Ow"er'. Addre.. <br /> <br />Fee !Simple Titleholder Namel <br /> <br />Fee [imPle TItleholder Addree. <br /> <br />JOB ADDRESS 175~3 Me r'C hal"lrVI II~ C I V'': Ie. <br /> <br />SUB IVISION ICV'~6.f-v'I<Mj 1+,115 I PARCELID#I ~S- ~S" at O/~c <br />(OBU,INfO FROM PROPERTY TAX NOTICE) <br />WO~K PROPOSED 0 NEW CONSTR E3 ADD/ALT 0 SIGN 0 MOVE D <br />o INSTALL REPAIR <br />PROpOSED USE D SFR 0 COMM ~ OTHER I FJ2. nc,L,. <br />TYP~ OF CONSTRUCTION 0 BLOCK 0 FRAME 0 STEEL 0 OTHER I <br /> <br />DEsfRIPTIONOFWORK t:;r~(-h ~ F.vn<:.L. We.'-C)cJ?", VctC <br /> <br />SUit'.: INGSIZE I 2.55;' I SQFOOTAGE I Ol!>'S /'nia./lfJ-. HEIGHT l, <br />....... ,c"'-"""~-"-__'_""''''''_:''_'''_____''''''C_'''~~~"""",,,,,,,,,_,,,,,,,,,, <br />D, BUILDING 1$ } 11 77. (J 0 , VALUA TlON OF TOTAL CONSTRUCTION <br /> <br />DEMOLISH <br /> <br /> <br />Oi <br /> <br />Di <br /> <br />PLUMBING <br /> <br />)$ <br />1$ <br />1$ <br />o <br /> <br />OTHER <br /> <br />ELECTRICAL <br /> <br />I <br />I <br />l <br />o <br />FINIS~iED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNa <br />~~~~~lI1\I'~~~~~1ii.~iiJ <br />~~~~~RE I '~11!~~ ~ j ;E~::~~ I ~ F~t~~ I <br /> <br /> <br />Afldress I License # I <br /> <br /> <br />;::~f~~~N I ;E~:~R~~ ~ FEE CURRENT ~ I <br /> <br /> <br />A~dre.. I license # I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />~ <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />W.R.EC <br /> <br />o <br /> <br />VALUA TlON OF MECHANICAL INST ALLA TlON <br /> <br /> <br />MECHANICAL <br /> <br />o <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIAL TY 0 <br /> <br />PLUM~ER <br />SIGNATURE <br /> <br />A~res, <br /> <br />MECH4NICAL I <br />SIGNATURE <br /> <br />Afre.. I <br /> <br />OTHER I <br />51GNA URE <br /> <br />COMPANY <br /> <br />~ <br /> <br />REGISlERED <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />License # <br /> <br />COMPANY <br />REG1S7ERED <br /> <br />~ <br /> <br />FEE CURRENT <br /> <br />L.:!L!:!...J <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />~ <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br /> <br />License # <br /> <br />-~~~~~~~~...l!4~~~-W:~~;;-2;[&'~~..R;;-~Mt:~.:.:er~~1k-~.,nJti'~~t= <br /> <br />Al1ach (2) Plot Plans; (2) sets of Building Plan.; (1) set of Energy Form. <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Sanitary Facilities a 1 dumpster <br />All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans, <br />....PROPERTY SURVEY required for all NEW constructIon. <br /> <br />SIGN P~RMIT <br /> <br />~.3II!iM-~~~~~-~~~~m.~~~~~.ft.~~~.:ft;!i'ii~~.~:-;P:.&M~'R~~mj~L~~:m-I; <br />s: <br />Fill ut application completely, <br />Ower & Contractor sign back of application, nofatized <br />If er $2$00, a Notice of Commencement i. required. (AlC upgrades over $5000) <br /> <br />Age t (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER E COUNTER PERMITTING (Front of Application Only) <br />Re ofs Sewers Service Upgrades NC <br /> <br />Driveways <br /> <br />Fences (PloVSurvey/Foolage) <br /> <br />/---'---'''"., <br /> <br />~&9?- <br /> <br />