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<br />Date Received <br /> <br /> <br />City of ZephyrhlllS I-"ermlt AppllCaUUll <br />Building Department <br /> <br />813-780-0020 <br /> <br />Fee Simple Titleholder Name <br /> <br />Owner Phone Number <br />FL... ~""?:s.-4 Cr- <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />I L./ t Cj f-h ~i. 2-. <br /> <br /> <br />\5 F L.... 'S.~ S-C("d- LOT # I <br /> <br />PARCELlD#ht -~0-~\ - ()OlO '-0'l800-00:10 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SUBDIVISION <br /> <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />B <br />D <br />D <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE <br /> <br />o <br /> <br />DEMOLISH <br /> <br />D <br /> <br />D <br />D <br />D <br /> <br />WORK PROPOSED ~ <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK I ~Q.. ..... nxJf- <br /> <br />I <br /> <br />1111111"'1"1111".'111111'1...'1"'11.."'1111"1'1111,11111"11"'.'...'11".'1,,"1"1"1111,11111"'..'1"."1"111"-'1'11111'.""111"111" <br /> <br />1$ ~ ~ liD ,f9- I <br />1$ I <br />1$ I <br />1$ I <br /> <br />o GAS D ROOFING D SPECIALTY D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111I11111I111111111111111111I11111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111 <br /> <br />BUILDER I <br />SIGNATURE <br /> <br />Address I <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />W?l <br />D <br /> <br />OTHER I 'K{J(')-t-- <br />STEEL D OTHER I <br /> <br />HEIGHT I <br /> <br />SQ FOOTAGE I <br /> <br />BUILDING SIZE <br /> <br />BUILDING <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />CJ <br /> <br />PROGRESS ENERGY <br /> <br /> <br />D <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />gJiJ <br /> <br />PLUMBING <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 />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # I <br /> <br />~ MaVl RC;yi, r1~ +V/_' <br />, Y / N I FEE CUR~NT I Y / N I <br /> <br />License # I c..cc...l ?>d 5 50'S <br /> <br />Address <br /> <br />OTHER _ <br />SIGNAun:tE <br /> <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. Requiredonsite, Construction Plans, Stormwater Plans wi 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 onsile, Construction Plans, Stormwater Plans wI 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 />Address <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />111111111,...111..111.....11..11..1111111..11.....111111...111.......111.........11.....11.111111..11.1111..111..111111..111111111111...111..,1111 <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. (A1C upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attomey (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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />