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<br />813-780-0020 <br /> <br />City of ZephyrhiJ/s Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address I ~!5o;). <br /> <br />Fee Simple Titleholder Namel <br /> <br />ue <' 0 (: D Owner Phone Number <br /> <br />tJ , Roc~'-1 ChI ('l\- ~ (. Jl I U50 Owner Phone Number I <br />-rc~\ Fi.... l 1 <br />-, . ,- I .3"3 ~o 70wner Phone Number <br /> <br />Fee Simple Titleholder Address I <br /> <br />! r.<o,rio <br />1 <br /> <br />JOB ADDRESS <br /> <br />mou'<1.Q n l-\-ol (O~ '1)i~ <br />I PARCEL 10# I <br /> <br />B <br />o <br />o <br /> <br />Amp <3c1 ~D \.f 0l-\-S <br /> <br />SQ FOOTAGE 1 1 <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DESCRIPTION OF WORK <br /> <br />8 <br />o <br />o <br />I lOb <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />BUILDING SIZE <br /> <br />LOT# <br /> <br />o <br />o <br />o <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 DEMOLISH <br /> <br />OTHER r <br /> <br />S~~IE~+D. 0'":_ <br />I- +--. S+-c~l~ <br />HEIGHT I <br /> <br />"111111'11""1111"11"'1'1'11'11"111'11"1""1'"1'1'11""1'1"'1"1"'111"1'11"11'1'11111"11'11'1'1""11111'1"11'1'1'111'1'11111"'111 <br /> <br />o BUILDING [$ I <br /> <br />o ELECTRICAL 1$ c>ol <br />. 2oc.o. - . <br /> <br />o PLUMBING 1$ I <br /> <br />o MECHANICAL 1$ I <br /> <br />o GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo <br /> <br />1I1I11111111111111II11111111I1111II111I1111111111111111111111I1111I11111111111111111111II111I11111I11111111111I11111111111111I11111111111111111111 <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />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 />BUILDER <br />SIGNATURE <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REG'STERED <br /> <br />Address <br /> <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br /> <br />MECHANICAL I <br />SIGNATURE _ <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br /> <br />Address ~ I1I1 III 'I . . . . . . . . . . . . . <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Y/ N <br /> <br />1 <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />I <br /> <br />FEE CURRENT Y / N <br /> <br />License # <br /> <br />13~~ <br />I Y/ N I <br /> <br />mor~ C:;j ~Y <!-/ N f'l2J. <br />FEE CURRENT L _ <br /> <br />License # <br /> <br />Y/ N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Y/N I <br /> <br />Y/N <br /> <br /> <br />I......"............,....,........,.,..,.............................."..........."....,..................,.............................,...." <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 />)VER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC Fences (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on pUblic roadways..needs ROW <br />