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--�'•( r l�'"� ! _ �� , <br /> e�a-�saoo2o � City of Zephyfiilis Permit Application Fax-813-784002'1 <br /> BuM1mg Department �O �'- �� a _ � � � <br /> ..J <br /> D�le Recefved Plane Contsct tor P�rmittlnq L <br /> T T"T 1 1 1 1 1 7 � TT7 <br /> " � f f�}( �c" ,` L �. <br /> OwnePaName OwnerPtwneNumbst .�_� �- 3`l' �t�1C�l <br /> : � � r�-' l <br /> Ownsr's Addreu '--' �' � L� � �t'.. � � � � '� �. c L J c _ +ti` �Ownar Phone NunWer <br /> Fee Simpie Titlehoidar Name �— � Ownet Phone Number �_—� <br /> Fae Slmpte TittenoM�r Address <br /> JOB ADORESS '� � � t Z (._ � 1 � . _ 1-Y � - - Y � f 1 ��5 '\ �-- �%`�` } LOT / � <br /> sueoivisioN PARCEL IDi 2� Lt�-�2 l-L���,C -:��.°- �,,_: -�_S ,-} G <br /> �osr��� Rnor �one�rr r�uc �anc� <br /> WORK PROPOSED e NEW CONS"fR 8 ADD/ALT Q SIGN Q � DEMOLISH <br /> INSTAIL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION � BIOCK � FRAME O STEEI � <br /> DESCRIPTION Of WORK � <i ' G.t t--�CCC_.n C,> * ;_,.�� ,�� f,� j ,;� � _ ' �� -,�� � <br /> BUILDINO SIZE � SQ fOOTAGE � HEIONT � <br /> �BUILDING '' � VALUATtON OF TOTAL CONSTRUCTION`'i �, ���-�- �� <br /> � <br /> �ELECTRICAL �� AMP SERVICE Q PROGRESS ENERGY O W R E C <br /> QPLUMBWG $ � � � � �� ^ <br /> � <br /> QMECNANICAL E VALUATION OF MECHANICAI. INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHE J FLOOR ElEVA710NS FLOOD ZONE AREA QYES NO <br /> BUIIDER �OMPANV r � ��s(` \ :f�� <br /> SI6NATURE REGR7ERED Y! N FE CURREN Y I N <br /> Address � \ U Laenu !f �� <br /> ELECTRICIAN � � COMPANY r <br /> SIGNATURE REGISTERED Y 1 N fEE CURREN Y! N <br /> ��� L�cen6e ff � _� <br /> PLUMBER I � COMPANY � � <br /> SIONATURE REGISTERED Y/ N FEE CURNEN Y/ N <br /> Addres� L�cen6e tk <br /> MECHANICAL � COMPANY <br /> SIGNATURE REGISTERED Y I N FEE WRREN Y/ N <br /> '��� L�cense N � � <br /> OTMER � COMPANY �—_ —� <br /> SIGNATURE REGISTEREO Y/ N FEE GURREN Y! N <br /> Addreas License ft <br /> IIIIIIIIIIIII IIIIIIIIIIIIIIIIIilllllllllllllllllliltliillllilllllll <br /> RESIDENTIAL Attach (2) Pla PWns, �2) sels of Bwldmp Plaris, ( t) set of Energy Forms, R-O-W Pertnrt tor new caretruction. <br /> M�nxnum ten (10) wwkmg daya atter eubmrttal date Requred onsrte, Caistruction Pians, Stormwater Plans wf Sdt Fence �nstatled, <br /> Sankary FaalAees 8 4 dumpster, Srte Work Permit for aubtlrv�aqnellarge prp�ects <br /> COMMERCIAI. Ahach (3� oomplete seta of Bu�dinp Plans plus a Lde Safety Page, (1) set oi Energy Fams R•O-W Permrt fw new constructron <br /> Mmunum ten (10) workxg days after eubmRtal tlate Reqwred onsne, Caishudion Plans Stormwater Plans w! Sttt Fence installed <br /> Sanitary FaaFtros 8 1 dumpeter Sde Work Permrt for afl new projecty AB commeraai requirements must meet compl�ance <br /> SION PERMIT Attach (2) sets oi Enpuiee�ed Plans <br /> ""PROPERTY SURYfV reqixred fo� atl NEW construdion <br /> Dlrscfbn�: <br /> F�II out appication completely <br /> Qwner 8 Corrtradw sign back of app�cation, no[ar¢ed <br /> M over f2500, a Notice d Comnwncemsnt fs rpWrod. (AIC upgndes ovx f7500) <br /> " O�gent (iort�e contractorl or Power ot Attorney (for the w�ner) �+ould be someone wRh notar¢ed letter irom owner auttqr¢ing same <br /> OVER THE COUNTER PERMITTING (Front of Appl�cation On1y) <br /> Reroofs R shingles Sewers Serv�ce Upgrades A/C Fences (PIWSurveylFootage) <br /> Driveway�Not over Counter �t on public roadways needs ROW <br />