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$�:�aso-°°2° City of Zephyfiills Permit Application Fax-813-780-0021 <br /> Building Department �'��� <br /> Date Receive�d � / ` �v � / p�e �tact for Permittin g 7 _ "7 Si�f � <br /> - rrrrr - r� -- r <br /> Owners Name ( Y�r�j' �' � Owner Phone Number gb �j -� 5)3 -�} �� <br /> Owner's Address I r� 1�} �.`� L-�; � IG.n C� <br /> ' � r Owner Phone N�xnber <br /> Fee Simple Titlehnlder Name Owner Phone Number �— —� <br /> Fee Simple Titlehdder Address <br /> JOB ADDRESS 3 g OO ' ��r� Z {► r ,` � =j � � �/ � LOT # �� <br /> �J <br /> SUBDIVISION PARCEL ID# <br /> (OBTAtNED FROM PROPERTY T/UI NOTICE� <br /> WORK PROPOSED e NEW CONSfR 8 ADD/ALT � SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR � COMM � OTHER <br /> TYPE OF CONSTRUC110N � BLOCK Q FRAME � STEEL Q <br /> DESC(bPTION OF WORK = n �( �C � a� 1 X (,. �� <br /> BUILDING SIZE � SQ FOOTAGE HEIGHT <br /> BUILDING S C VALUATION OF TOTAL CONSTRUCTION <br /> O� � <br /> QELECTRICAL $ AMP SERVICE O PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ / ' � <br /> / � <br /> MECHANICAL Z �� � <br /> 0 $ VALUATION OF MECHANICAL INSTAILATION <br /> C��S Q ROOFING � SPECIALTY �� OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA OYES NO <br /> BUILDER � COMPANY (�VPJ�I���I� �C''N'Cf�✓��Z�� � ! �� � <br /> SIGMATURE � REGISTERED Y/ M FEE CURRE� Y/ N �� <br /> `/ ' 2 -t-Il <br /> Address ��{ {�Sif���' ��L� L��� C'L c� License # e�C �l �v� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> ��� License # � <br /> PLUMBER COMPANY <br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address <br /> License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Addf�SS LICCnS2 # � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address <br /> License # <br /> Itlllllllllllllllllllllllllllll lllllllllllllllllllllllllllllllllll l <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 d�npster, Site Work Pertnit for subdivisions/Marge projects <br /> COMMERCIOI ex�.-n rz� ...,.....�e.,. .....- -' ^---•�-- - ^• - <br />