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Date Received City of Zephyrhihs Permit Application Buildinb Department Phone contlt for Permitting Fax-813-780-0021 813-780-0020 .- Owner's Name Owner's Address I s () tA ~ Fee Simple Titleholder Namel I I I I I I I I - P~RCELlD#III- 1... ~ -)../- DolO -J..lt (;0- 00 frO I (OBTAINED FROM PROPERTY TAX NOTICE) D NEW CONSTR r::><l AqD/AL T D SIGN D MOVE D DEMOLISH ~ INSTALL c==J RlPAIR PROPOSED USE D SFR c==J COMM D TYPE OF CONSTRUCTION D BLOCK D F+ME D DESCRIPTION OF WORK I ~ ;I. w0J.b<-.1.&". f' ~ Jl::J BUILDING SIZE II A XIO I SQ FOOTAGE c== _ HEIGHT I I ,.,..1111.1111...11.......11...111..1111...111...11111.11...111.........1111...111...11'....11...111........111111.....111111.............1......... D BUILDING 1$ ~ I 0 0 ~ VALUAr~ION OF TOTAL CONSTRUCTION D ELECTRICAL 1$ AMP S . RVICE c==J PROGRESS ENERGY D W.RE.C. D PLUMBING 1$ D MECHANICAL 1$ D GAS D FINISHED FLOOR ELEVATIONS I 7 3- 36 tJ I 7Y7- 57,2 '1 Fee Simple Titleholder Address .' JOB ADDRESS SOd.. <t 19TH ~ LOT # .~ SUBDIVISION WORK PROPOSED OTHER STEEL I D OTHER I ROOFING c==J I VALUAflON OF MECHANICAL INSTALLATION S~EcrAL TV D OTHER FLrOD ZONE AREA DYES DNO SIGN PERMIT 1 I I I I I I I 1 I License # I I I 11111111I111111 111111111111111111I111111I1111111111111I111111111111111111I1111111I11111111111II11111111111111111111111111I111111111111111111111111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Storm water Plans wi Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work PermiHor ~Ubdivisionsllarge projects Attach (3) complete sets of Building Plans plus a Life :lafely Page; (1) set of Energy Forms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. ~equired onsile, Construction Plans, Stormwater Plans wI Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Pennit for all new projects. All commercial requirements must meet compliance Attach (2) sets of Engineered Plans. I ....PROPERTY SURVEY required for all NEW constr~ction. 11111 111111 1111111 I 1111 I I" II 11111 III" II I 11111 I I 1111111" 11111111 1111]111 III" II 111111 III 111111111111 I I I I 11111111111 11111111111111111111111 I 111111 Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A1C upgra es over $5000) Agent (for the contractor) or Power of Attorney (for the owner) would bel someone with notarized letter from owner authorizing same I Fehces (Plot/Survey/Footage) I BUILDER SIGNATURE ~I~RENT License # I Y/N Address ELECTRICIAN SIGNATURE COMPANY REGISTERED Y I N FEE CURRENT Y/N I I II II I License # Address PLUMBER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # MECHANICAL SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # OTHER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address COMMERCIAL OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AlC Driveways-Not over Counter if on public roadways..needs ROW