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<br />#- C!:JJ~ t? Fax-813-780-0021 <br /> <br />-- ~ I -"-..~ I <br />aw:....N8me . ~~e.- CV'f_s.+ MI \-+ 'P~t. OwnwPhane......... t8 -"18.)..-<el\;} <br />0Wner'. Address I ~ () ~~ G-c...i-l i:>i. Jd- I Owner Phone Number I <br />F.. SImple TltIehoIder N8me I I Owner !'hone Number I <br /> <br />Fee Simple TIaeholder AddrMa I <br /> <br />lCa.lO'O ~r~ <br />I~~~ C:.~S-t- <br /> <br />813-780-0020 <br /> <br />JOB ADDRESS <br /> <br />SU8DMSlON <br /> <br />WORK PROPOSED <br /> <br />PROI'OSED USE <br />TYPE OF CONSTRUCllON <br /> <br />DE8CRJP11ON OF WORK <br /> <br />BUILDING SIZE <br /> <br />D BUILDING <br />CEr' ELECTRICAl <br />D PLUMBING <br />UZf MECHANICAL <br />0 GAS <br /> <br />City of ZephyrhiHs Permit Application <br />Building Department <br /> <br />I <br />I <br />I <br />I <br />S-t- I LOTI I/Cp I <br />I PARCELlI>>lo~.J~' dl. ~ ~O. 000 DI.9. ()C/~ I <br />(OBTAINED fROM _RTY TAX NO"llCEI <br />D NEWCONSTR E3 AODfALT D SIGN 0 MOVE 0 DEMOLISH <br />l:B"" INSTALL REPAIR <br />D SFR 0 COMM 0 OlliER I , <br />o BLOCK 0 FRAME 0 SlEEl 0 OlliER I I <br /> <br />I ?'-<.~-" cJ 0 elk" I?, See.... w It ok",,) J;", ~ G- F:C "...f,.l1 <br /> <br />- SQ FOOTAGE I~ , HEIGHT I I <br />: <br /> <br />,S <br /> <br />1$ L ~S . t>,:) <br /> <br />1$ <br /> <br />1$ SJ J'S. 3Q <br />o ROOFING <br />FINISHED flOOR ElEVATIONS I <br /> <br />I VALUATION OF TOTAl CONSTRUCTION <br />I AMP SERVICE <br /> <br />I <br /> <br />I VAlUATION OF MECHANICAl INSTALLATION <br /> <br />o SPECIAL TV 0 OTHER <br />I FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />o WR.E.C. <br /> <br /> <br />:=RE I <br /> <br />AddrMs <br /> <br />~ <br /> <br />PUIIIIII!R <br />SIGNATURE <br /> <br />AddrMa <br /> <br />AddrMs <br /> <br />OlHER <br />SIGNATURE <br /> <br />Address <br /> <br />COIIPANY <br />REGISTERED <br /> <br />FEE~ <br /> <br />L!!!LJ <br /> <br />Y/N <br /> <br />license # I <br />I fV\r.tt5 cJFEE-:RREE;;( ~L. <br /> <br />Lioensd 1E:e-<90 O'i7t~ <br /> <br />L:!.!1LJ FEE CUlAI!NT <br /> <br />L.!.!lLJ <br /> <br />License # I <br />I A- &Ci\;./" ~~..f.;.t.~,,-~o~ <br />L!L..!LJ FEE~ L!!!LJ <br />License # I c.AL 0 S"I <.i !?l ~ <br /> <br />L:!.!1LJ FEE CUlAEHT <br />License # <br /> <br />L!!!LJ <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />AIbIch (2) Plat PI8nI; (2) .. at Building PIlw1a; (1) set at Energy Fanns; R.o-W Permit for new oonslrucIion, <br />Minimum ten (10) WIllf<ing days efter submillal dele. Required 0I'l$lIe. Construction PUwls, Stormwater Plal'l$ wI Silt Fence Installed, <br />SMil8ry Facilities & 1 dumpsl8r; Site V\Iorl< Permit for sub<f1V1sionsIlllrge projects <br />Attach (3) complete .. at Building PIlIns plus a lire Safely Page; (1) set at Energy Fonns. R.o-W Permit for .- construction. <br />Minimum ten (10) WIllf<ing days after submitlal dale. Required OI'l$lIe, Consttuc:tion Pl_, Stormwater Plans wI Sill Fence Installed, <br />Sanillry Facilities & 1 dumpst.... Site V\Iorl< Permit for 811 .- projects. All comrnen:iaI requirements must meet compliance <br />Attach (2) 88Is at E~ Plans. <br />-pftOPERTY SURVEY required for all NEW construction. <br /> <br />~: <br />Fill out application completely. <br />Owner & ConIreCIor sign back of appliCation, notMzed <br />If over $2SOO, . NaIIce at ~ IsI'llCll*ed. (AIC upgI'lIdes _ saooo) <br /> <br />- Agent (for the conlnlctor) or Power of AIIomey (for the owner) would be someone with notarized IeltIIlr fnlm owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of AppliCation Only) <br />Reroofs Sewers Service Upgrades AJC Fences (PIotISurveylFootage) <br />Oriv_llYs-Not C>V8f" Counter if on public roadways..needs ROW <br />