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<br />_ 813-780-0020
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<br />City of Zephyrhi/ls Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Date Received
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<br />CVa-~
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<br />1~4 S" s:>
<br />4) cr9..f jJ ,/
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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 />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Name/
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<br />Fee Simple Titleholder Address
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />I
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<br />1
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<br />B NEW CONSTR B
<br />INSTALL
<br />DSFR 0
<br />o BLOCK 0
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<br />DESCRIPTION OF WORK / II ( vA c:;. I<- ~ (~ c Itcv"---"5P
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<br />BUILDING SIZE I SQ FOOTAGE / / HEIGHT I I
<br />-ry'I"""II"'III'IIII"II"III'III'IIIIII"I'I""'I''1111"1'1'1""'11111111111111'1111"11"111"'1'1'1'1'11""111111"'11'1'1'1111'11"'111
<br />o BUILDING 1$/
<br />. . VALUATION OF TOTAL CONSTRUCTION
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<br />o ELECTRICAL 1$ I
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<br />o PLUMBING 1$ I // .
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<br />o MECHANICAL 1$ I S 6'''. ~-I VALUATION OF MECHANICAlINSTALLA(,ON 41:0 g 01 J
<br />D r--l ~~~~--
<br />CJ GAS ROOFING L-..J SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />111111111111111111111111111111111111'111111"11111111111111111111111111111111111111I1111I11111111111111111I1111111111111111111111111111I1111111111
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<br />PARCELlD#/
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<br />LOT #
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<br />WORK PROPOSED
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<br />(OBT A/NED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
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<br />OTHER I
<br />o
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<br />DEMOLISH
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<br />PROPOSED USE
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<br />TYPE OF CONSTRUCTION
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />o
<br />o
<br />o STEEL
<br />04/
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<br />OTHER I
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<br />AMP SERVICE
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<br />o
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<br />PROGRESS ENERGy....
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<br />...0
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<br />W.R.E.C.
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<br />BUILDER COMPANY
<br />SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br />Address License #
<br />ELECTRICIAN I COMPANY
<br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N
<br />Address I License #
<br />PLUMBER I COMPANY
<br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N
<br />Address License # I
<br />MECHANICAL I ~~~r C~yLr~
<br />SIGNATURE Y / N FEE CURRENT Y / N I
<br />Address License # I I ,? .2....
<br />OTHER COMPANY
<br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N
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<br />
<br />
<br />Address License #
<br />1111111111111I111111I1111I111I11111111111111111111111111111111I1111111111111I1I11111111111111111111111111111111111111111111111111111111I1111111111
<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 />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
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<br />Di~~~t;~~~': ' , . . , . , , . , . , , . , , , . . , , , . . , , , . . , . , , . , . . , , , . . , , . . . , , , . . , , , . . , , , . . . . , , , , . . , , , . . . . , . . , . , . . . . . , , , . , , . . . . . , . , , . , . . . , . , , , . , . . . , . . , . . . . . , . . , . . , .
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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 PERMITTING (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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