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<br />813-780-0020 <br /> <br />City of Zephyrhllls Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />~.~ 101/ <br /> <br /> <br />Fee Simple TitlehOlder Address I <br /> <br />~oo"_cl."_~".o ,----, ~.. [ L <br />--~".' -'-0,-, ._~~:=:::-.. ~I~ :8~:3~;"1.mj <br /> <br /> <br />Owner Phone Number I I <br /> <br />Owner Phone Number I I <br /> <br />I <br />I <br />I <br /> <br />~r'" <br /> <br />Owner'e Address I (04 \.;).. 4,j\.LM.~ "\\~ <br />Fee Simple Titleholder Name I ~ \ t.:\ <br /> <br />JOB ADDRESS <br /> <br />1(,,+1;;). ~ <An"" "$f': '"!>,... <br />I ~\ \)..(,A O",\U!. PARCELlD#lo3 '~lo'do\' Ol.;).() -00000 . 09~ <br />(081 AINED FROM PROPERTY TAX NOTICE) <br /> <br />LOT# <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />B <br />CJ <br /> <br />ADD/AL T <br />REPAIR <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />Q BUILDING <br />b 1 ~LA,OO <br /> <br />D ELECTRICAL <br /> <br />D <br /> <br />D OTHER I <br />TYPE OF CONSTRUCTION 0 BLOCK CJ FRAME D STEEL D OTHER I I <br /> <br />DESCRIPTIONOFWORK I ':::hb{G.s~ (j'O'()\ ~~ ~I )lrtNl f(llloy.lre <br /> <br />BUILDING SIZE I SQ FOOTAGE I ' I HEIGHT I I <br />~~~~~~~~~~~..~:-1','.=."~......!it..i.'!!~~~~~~~~~~~~~ <br />1$ " ~ O<,L , <br />-L.r~\ lo Ce. '""' <br /> <br />1$ I <br />1$ I <br />1$ I <br /> <br />o ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />PROPOSED USE <br /> <br />SFR <br /> <br />COMM <br /> <br />VALUATION OF TOTAl CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />CJ <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W,R.E.C <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />~~e., vi <br /> <br />D <br />D <br /> <br />PLUMBING <br /> <br />o <br /> <br />GAS <br /> <br />SPE61AL TY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />Addre.. <br /> <br /> <br />License # <br /> <br />~ <br /> <br />----_~_il~-.aiIL_,"" <br /> <br />D ~IIA;IA"-~j)Oi>~7'- <br /> <br />~ FEE ENT Y <br /> <br />IG1C/<f~78 I <br />I <br /> <br />'lI~L LIcense # I E:C_J3ro ,.~S"') I <br />I~ fil?:V!J ~ 1<- I <br />lK:ens€ # I c.#c /</-9P 7L.3' I <br />I <br />I <br />I <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Addr..s~ <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address L <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Addre.. , <br /> <br />COMPANY <br />REGrSiERED <br /> <br />L..!.L.tU <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />L..!.L.tU <br /> <br />FEE CURRENT <br /> <br />L.!'.!..!:U <br /> <br />License # <br /> <br />'J.-~~~~~~~~~~~~~':l"'~~&~~r:.{~~~~~~,JJ1:;;'~.M'~c:~.n~~.n:,;;~xn~~ <br /> <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal data. Required onstte, Construction Plans, Sanitary Facilities & 1 dumpster <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance. <br />SIGN PERMIT Attach (2) sets of Engineered Plans_ <br />....PROPERTy SURVEY required for all NEW construc1ion. <br />~:;t!M.~~~~~~"2!.~~~~.~~-8~~ffi!t~'~~~~.h~~,i1G--:;.iiI;,.ii!~~~~--m~J~~~:mJ; <br />Directions: <br />Fill out application completely_ <br />Owner & Contractor sign back at application, notarized <br />If over $2500, a Notice of Commencement is required, {Ale 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 NC <br /> <br />Driveways <br /> <br />Fences (PloVSurvey/Footage) <br />