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<br />813-780-0020 <br /> <br />Date Received <br /> <br /> <br />City of Zeph~r~i1ls Permit APPlicationjr(' ~:'1J..Q Fax-813-780-0021 <br />Building Department ' .,J1) I /~/J~' <br />\ ;)-1 -5G;~~ -':'""-0 _ <br />r;J. 7 __ (Ce.t0 ~ <br /> <br />Owner Phone Number '6\ 3 - &10 d-. - 3L\, <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />6 'd-5-67 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br />JOB ADDRESS /1 g Go s (01. lA-tJt:.11 ..t V c, 2ePh'-r J..h~ lie;, r- L-, <.2..<;;L-fO LOT # I I '--( <br />SUBDIVISION I A\QYyl () \ n uo. J.. I PARCEL ID#I <br /> ~ (OBTAINED FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED ~ NEW CONSTR B ADD/ALT D SIGN D MOVE D DEMOLISH <br /> INSTALL REPAIR <br />PROPOSED USE D SFR D COMM D OTHER I <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I 'VbO \ <br /> <br />DESCRIPTION OF WORK 00\ \ '" SA c... \ \ <"'--- ~ c..rv" <br /> <br />BUILDING SIZE HEIGHT I <br />Tn""'I"IIII'I'III'III""II"'II"'IIII'I"III'III'11111'11'1""111"11111111"1111111111'1'11111111'11'1111111'111'1'111"111""1"11111111 <br /> <br /> <br />~ ~S~ .<..\-3 <br />lJ.oo y 00 <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 />PIE ...- ~d) <br />!'-iDe- / <br /> <br />ELECTRICIANi 0 A <br />SIGNATURE _ . ~ <br /> <br />Address <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br /> <br />Address <br /> <br />License # <br /> <br />~ A"~'~'Mvol <br /> <br />~~PANY <br />REGISTERED <br /> <br />I \):~ (~~~ <br /> <br /> <br />License # I <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE , <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I License # <br />111I1111111111111111111111111111111I111111111111I11111I111I1111111I111111111111111111111111111111111111111111111111111111111111111I111111111111111 <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 onsile, 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 />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />SIGN PERMIT <br /> <br />...,111..11...11,...11..1111111....1111111111.111,.............11................................................................1",..,.......,.1 <br />Directions: <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 (PlotlSurveyIFootage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />~, : <br />