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<br />City of Zephyrhilla Permit Application <br />BuIIdirlg DepIrlment <br />:,-:~~l\:~'iP~<7 ~:-:-"~?-D~~ r> <br /> <br />Owner'sAddnlu 13 'j)(.;,.l.Lj .c.,.::. ~--v <;; OwnlIrPhoneNumber I <br />Fee SImple TltWIoIder N.-I Owner Phone Number I <br /> <br />813-780-0020 <br /> <br />Fex.a13-78lJ..OO21 <br /> <br />~ <br /> <br />Fee Simple Titleholder AddreM I <br />/38&3y <br />I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />lYPE OF CON$TRUC11ON <br /> <br />DE8CRlP1lON OF WORK <br /> <br />BUILDING SIZE <br /> <br />2~-P~~/L/ ..... LOT' I <br /> <br />pARCEllDllo<::. u, -l./.aooo- "~()(l -UC!()(", <br />1000MED _ PROl'IRIYTAX NlI11CEI <br />SIGN 0 MOVE 0 <br /> <br />eR5Y~ <br /> <br />G- <br />O <br />o BLOCK <br />I :.DY~TI1Li_ <br />I <br /> <br />I <br />E3 <br />D <br />D <br /> <br />OTlfER I <br /> <br />D <br />o <br />o <br /> <br />NEWCONSTR <br />INSTALL <br />SFR <br /> <br />ADDIAl T <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOUSH <br /> <br />OlliER I <br />STEEL 0 <br /> <br />C<>o/t./A/6 ./}.P?U"'I'ICt:- j-;~'C- S;(;:>~,'_:-:<'i.cA/ -'SXS7C YY1 <br />sa FOOTAGe I I HEIGHT I I <br /> <br />VAlUATION OF TOTAl CONSTRUCTION <br /> <br />D BUILDING <br />D ELECTRICAl <br />D PLUMBING <br />D MECHANICAl <br />CJ GAS <br /> <br />IS <br />IS <br />1$ <br /> <br />IS 1,/ <tOO .0 <=> <br /> <br />o ROOFING <br />ANISHED FLOOR ELEVATIONS I <br /> <br />IWP SERVICE <br /> <br />D <br /> <br />W.RE.C. <br /> <br />o <br /> <br />PROGREss ENERGY <br /> <br />VAlUATION OF MECHANICAlINSTAlLATlON <br /> <br />I · ~td' <br />~\~~~ <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I./~ <br /> <br />CJ <br />I <br /> <br />SPECIAlTY 0 <br />FlOOD ZONE AREA <br /> <br />OlliER <br />r::::Jves <br /> <br />DNO <br /> <br />~O:RE I <br /> <br />AcIdNM I <br /> <br />~~I <br /> <br />AddrMs I <br /> <br />=~I <br /> <br />AddrMs I <br /> <br />:~I <br /> <br />AddrMs I <br /> <br />OTHER I ......?3~ I COMPANY <br />SlGNAlURE ~ . __ <br />A~ 1/J'3~o /.111<J~&VC'~- J-IciJ- /)4.DoCny' I <br /> <br />RESlOEN11AL AltlI::h (2) Plot Plana; (2) ... of ~ PlBns; (1) lei of Energy FemIa <br />MinImum ten (10) worI<Ir1J dlIya 8fter MlbmlII8l_ Required onslIe. Ccn8tn.octian PI8ns. Sanil8ry Facilities & 1 mmpster <br />Atl8ch (3) ... of BuIlding PWla; (1) lei of Energy Forms. <br />Mi'lmum len (10) ~ dlIya ....1IiImIIIaI dlIIe. Required onelle, CorllIlNcllon PlBns. Sa1bry F8CiIIlie8 & 1 a.npster <br />An CllI'IlIIMlIdlI ~ mu.-n.-~. <br />Altach (2) _of ~ Plans. <br />""""PROPERTY SURVEY requAd for.. NEWconstrucllan. <br /> <br />COMPANY <br />-- <br /> <br />L:!.!..!LJ <br /> <br />FIlE CURIll!Hf <br /> <br />L.1.!..!:U <br /> <br />LiolInM , <br /> <br />COMPANY <br />-- <br /> <br />L:!.!..!LJ <br /> <br />fEE~ <br /> <br />L.1.!..!:U <br /> <br />LicenIe , <br /> <br />COMPANY <br />-- <br /> <br />UL!LJ <br /> <br />FEE CURRENT <br /> <br />l.!.lli..J <br /> <br />Lic8n$e , <br /> <br />COMPANY <br />- <br /> <br />L:!.!..!LJ <br /> <br />FEE CURRENT <br /> <br />L!.!..!L.I <br /> <br />Lic8nIe" I <br />js;"4Ie/J",/ nKe- 69()/~C <br />UL!LJ FEl!CURRENT IN <br />LicenIe# l-sac?..~z.aud .:~af <br /> <br />COMIIIERClAL <br /> <br />SIGN PERMrr <br /> <br />Dlrec:tIclM: <br />Fur out eppIIcetion complelely. <br />Owner & Cornc:lor SIgn blIck of ~ nolIItz:8d <br />If _ $2SOO, . ~ tJI Con__ Ie........ (NIC........ over $IDIllI) <br />- Agent (lOr the CXlIlIr8cIor) or Power of AlIomey (for Iha ~ would be IIen*nI wlIh IlIlIarized IeIIer fran owner aulharizlng _ <br />OVER THE COUNTER PERMI1TING (FlOtt rA AppIleation Only) <br />Rercofa s.-r. Servica Upgrades AIC Fencas (PlotISl6\IeylFoolage) <br /> <br />DrIwwap--Not f7tIW ~ if on public 1'lllIdw8)ts..- ROW <br />