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<br />\0/ <br />~ 8~3-~ <br /> <br />Date Received <br /> <br /> <br />City of Zephyrhllla Pennlt Application <br />Building OepIrtment <br /> <br />F0813-780-0021 <br /> <br />Owner's Name <br /> <br />Owner's Address 5439 "--~ <br />Fee Simple TItleh0Ider ~ I <br /> <br />." <br />Owne'.~ Mum"', <br /> <br />"j ---I <br />. 33634 I <br />OWner Phone Mum..., <br /> <br />JOB ADDRESS <br /> <br /> <br />LOT # I J ~ l~1 <br />, <br /> <br />tJ~O-Qt(PO <br /> <br />~ <br />I <br />(OBTAINED l"ROM PROPIEItTY TAX NOTICE) <br />NEWCONSTR B ADOI~T 0 stGN 0 MOVE D <br />INSTALL REPAIR <br />PROPOSED USE . 41 8FR 0 COMM 0 OTHER <br />TYPE OF CONSTRUC11ON [i!J BLOCK r:;gn FRAMe 0 STEEL 0 OTHER I <br /> <br />DESCRIPTIONOP_ C~ Single ~ <br /> <br />BUILDING SIZE r 1() X4~rl Z" 8QI'OOrAGE I ~ ~ HIICIHT L <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />~ <br /> <br />DEMOLISH <br /> <br />D <br /> <br />BUILDING <br /> <br />l$ 8 I loB <br />'$ (nC/ g <br />[:J05d--- <br />I~ /5~U <br /> <br />o GAS 0 ROOFING <br />FINISHED FLOOR ELEVATIONS rn 0 . t <br /> <br />Addr... <br /> <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />AMP SERVICE l.0o <br /> <br />CJ <br /> <br />PROGRESS ENERGY . c:J <br /> <br />;-.JC) c... ... ) <br />RoW -- R.u:[) <br />Su.,V)~ <br /> <br />WR.E.C, <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D <br />D <br />o <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES ~NO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Ucen".l\l <br /> <br />ELECTRICIAN <br />SIGNATURE' <br /> <br />S & S Electric Co. <br /> <br />Addr... <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Addre.. <br /> <br />tESIDENTlAL <br /> <br />Attach (2) Plot ......., (2) .... oI8u/ldlng Plene: (1) .. 0I11netgy lIonne . <br />Mlnlnuw'ItIn (10) worIdna dIIya aftw 8UbmItt81 datL "equlrecl on...., Construction Pie"., s.nltary lReollltl.. & 1 dumpster <br />Attach (8) .... 01 BuIdInsi ......, (1) Nt Of .nergy 1Ionn.. <br />MInImum tin (10) WOI'tclno ~ .,.., IUbmtttIII dtI.. "equfNd onatt.. Conetrucllon Pie".. lanltary ~.oIlft1.. & 1 dumpster <br />/11M ~... NCIUI.,..... mutt meet oompllena <br />Attach (2).... or~ ....".. <br />~"'!WaY NqU/Nd for III N~ CIOftItruoIIon. <br /> <br />Ucen..l\l C Pc.. ~ 5" CJ <br /> <br />I Airt:ron .H~ting and Cooling , <br />MGIITMID r y / N I FEI! 00.......,. . I Y I N I <br /> <br />COIIP_CI'613q<1~. ~ ;~) ~ I <br /> <br />~ Y I N FlEE OUMaNT =1 YiN J <br /> <br />, Ucen..l\l I I <br /> <br />'v1ECHANICAL <br />SIGNATURE <br /> <br />Addre.. <br /> <br />)THER <br />;IGNATURE <br /> <br />Address <br /> <br />:OMMERCIAL <br /> <br />IGN PERMIT <br /> <br />trectlons: <br />Fill out appllC8tkln compl_. <br />Owner & ~ elan back oIlP1*/1tlOn. notIlI'Iud <br />If over $2SOO, . NotIoe tIl1IC_~.. NquINd. (AIC U...... OVW $8000) <br />Agent (for the ~ or Poww of Attorney (for the owner) WOUld be eomtone with notarlzeclletter from O\Wler luthottzlng ..me <br />VER THE COUN1'IM P.....I' I bolO (Fftmt 01 Appllcetlon Only) <br />Reroofs Sewwa 8ervtoe Upgredee Ale Pencee (PIot1SurveylFootag.) <br /> <br />Drlveway&-Hot over Counter If on public roadways..neede ROW <br />