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• 813 730-0022 City of Ze.phyrhiiis Permit Appfication Fait 813.730..0G21
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<br /> Date Received i 5-/ 3.- t 0
<br /> 1 Phone Contact for Perm Iting I v i i ,,I," ,...,- -- 4' .,- ..,-• k.:,'• '
<br /> Owner's Name - ',' ,., , ::: ,, •••;.- , '- L ''''' .• ' "..' ' ' " 4 ' ,. clwner .hone Number •,..,-;,.. i ...•,, i ....„- •s- --
<br /> Owner's Address ki. , ,•= ... 1 i •,, '...,.„ kA . 1 :2 , ; -t-,.c ,:,...;,... ;.. ]!,,...; 'e- ,,, owher Phone Number ,
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<br /> Fee Simple Titleholder Name i Owner Phone Number
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<br /> Fee Simple Titleholder Address 1 —
<br /> JOB ADDRESS ,, , . „: •-, LOT I
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<br /> SUBDIVISION 1 PARCEL ID# i -=•-<•4 ' r' I - t. -.. i L • '
<br /> (OBTA.1140) FR= PR CPERTY TAX NOTICE)
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<br /> WORK PROPOSED 1 NEW CONSi _•,<•?..".•=° .A:'.,32dAL7 I, i S4GN 71 MOVE 1 ; DEMOLISH
<br /> 1 1 . iNSTALL REPAR 0; \o„, i -, ,
<br /> PROPOSED USE L j SR I CO:! r...74 OTHER I rt [ ik:' , , .....;n ::"...":,-, I 1-4-,L.:1 . .. , - ,- , I
<br /> TYPE OR I:DNS I BL.00,K, 1 i ,,' AME .17 S l'EEL = CI HER I I
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<br /> DESCRIPTION OF WORK 1 v •-• = `-•,--- L ,-.., , -6 -1 - 4- , ; t.:- %.-- i V ' • ' - ,k." , - ' -.- ""'"` ' ,
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<br /> BUILDING SIZE ___,1 SQ FOOTAGE I ; HEIGHT
<br /> fl BUILDING ig
<br /> VALOATiON OF I C.TAL OONSTRUCTIOIS :
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<br /> CZ ELECTRICAL IS , ,.-, .. , ..„ ., 1 AMP sERv] 0E 1 I PRCGRESS ENERGY 11 W.R E C
<br /> r--- PLumeING ' 0
<br /> 1 MECHANICAL .S VAL. lATlOtS OF MECHANICAL INSTALLATION
<br /> ED GAS = ROOFING 1 .--- 1 SPECIALTY = OTHER
<br /> FINISHED FLDOR ELEVATiONS i FLOOD ZONE AREA 1 [YES L _INC
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<br /> BUILDER I COMPANY
<br /> SIGNATURE I REGiSTERED 1 01 N 1 FtFE CURRENT l Y I N I
<br /> Address I boeme 4 1
<br /> ELECTRICIAN 1 COMPANY 1
<br /> SIGNATURE i 317155 I a` l q 1 FEE CURRENT 1 0 I N I
<br /> Address I 5<1 533
<br /> PLUMBER 1 COMPANY
<br /> SIGNATURE REGiSTERED LY . ,.... 12 . S j FEE CuRRENT 1 1 j
<br /> Address
<br /> 1 License 4 I
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<br /> MECHANICAL 1 .. • PANY I
<br /> SIGNATURE 1 1 s,' I N f TEE CdAIKEST - 1 'ON i
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<br /> Address I A i Tall License # .
<br /> ANY '
<br /> SIGNATURE — OTHER COM
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<br /> .IIIIL R. RED - * 1011111 r•EE coke ENT 1 YIN I
<br /> Address f' 3 ti: `• --‘, 1 ',..',:-`, :s.i. • : ::2: 1 C.= :,...- 3 .- 1 ; :1 - 1 ..4 •i :• ', fi, 31....: License #
<br /> RESIDENTIAL Attach (2) Plot Piens.: ;2) sets of Ballain Plains; •(1) set ct Energy FoFms. R.OAV Permit "or new construction.
<br /> mum ten (10) ve553res3 05y5 after sabmittet date Resumed onsite ConMfoction Plans, Storrawater Plans str Si : I Installed,
<br /> Sanitary F•actlites & 1 dtrep•stet; Site 'Work Pa<s for subdtvis;onsi:arge orolec
<br /> COMMERCIAL Attan (3) c serz of Lai:ging Pens talus a Lee Safety Page, (1) set 53 3<20230 Forms R-O-W Permit for new consa=ion
<br /> Miril mum fen 0) ya.ssing days after submittai date. Regidred cnsXe, Coistuston Pans, Stormwater Pars , si Silt Pentad installed,
<br /> Sanitar,r Facilis 0 1 eumpster Site Work Permit for all qeds All corrmercial requirements must meet compliance
<br /> SIGN PERMIT Attach (2) sear of Engineereg Piens
<br /> ... "PROPERTY SURVEY required for A:i ..iEV
<br /> FR out appi..kation compleref):
<br /> Owner Er. Contractor sign 100 of itippl4stion, solarized
<br /> If over $2500, a Notice of Commencement is regsnred. (AIC upgrades over $0000)
<br /> " Aoeht (tor <11<1 conetictc,t or Rower nt Attorney (for Me owner) ant:mkt be someone with norized lettef from owner sethotizitv, same
<br /> OVER THE COUNTER PERMITTING (From of Applicator Coy;
<br /> Reroots Sewers Semine Upgrades A/C Fences (Pins(SeNeyfFootage)
<br /> Driveways-Net 053 r Counter 1 (x public itr.:) seeds ROW
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