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Cit of Ze h rhilis Permit Application Fax-813-780-0021 <br /> 813-7�0-0020 Y P Y <br /> , Building Department <br /> Date Received Phone Contact for Permlttin J� � — ��� <br /> Owner's Name �C �/ Owner Phone Number �� " / J � � �� / <br /> �� ���� �� Owner Phone Number ��� �� � � �� / <br /> Owner's Address , <br /> Fee Slmple Titleholder Name <br /> Owner Phone Number <br /> Fee Simple Titleholder Address � <br /> JOB ADDRESS ,� � � �1. � �/��' � � ��� 3 � LOT # <br /> SUBDIVISION �� '���' <br /> PARCEL ID# J ���� � C � � �� �'��/� <br /> (OBTAINE� PROIA PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR � ADD/ALT Q SIGN Q MOVE �J DEMOLISH <br /> � INSTALL REPAIR <br /> —7 SFR 0 COMM Q OTHER <br /> PROPOSED USE CC-1 � STEEL Q OTHER � <br /> TYPE OF CONSTRUCTION Q BLOCK �, <br /> DESCRIPTION OF WORK `' " � <br /> BUILDING SIZE SQ FOOTAGE �� C.Y HEIGHT <br /> Q BUILDING $ • i1�� Q� VALUATION OF TOTAL CONSTRUCTION <br /> �7 <br /> � ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY �] W.R.E.0 <br /> 0 PLUMBING $ .] � j(� <br /> �� !/� T <br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALI..ATION <br /> Q GAS ROOFING 0 SPECIALTY Q OTHER <br /> �,2���� 3 <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES QNO <br /> ; <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> i <br /> Address Llcense # <br /> I ELECTRICIAN COMPANY <br /> � SIGNATURE REGISTERED Y I N FEE CURRENT Y/ N <br /> i <br /> Address License # <br /> ' PLUMBER COMPANY <br /> ' SIGNATURE REGISTERE� Y/ N FEE CURRENT Y/ N <br /> ! Address License # � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � � <br /> � OTHER % COMPANY N/y�iZ�FT�`�i� l' -� �� ��'N <br /> SIGNATURE ` l4'l 2/�2 REGISTEREO Y/ N FE CURRENT Y/ N <br /> Address /� A,��— �/ � � S� j Llcense # I �1��� �` O `7" / �� <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Enargy Forms <br /> Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Sanitary Facilities 8 1 dumpster <br /> COMMERCIAL Attach (3) sets of Build(ng Plans; (1) set of Energy Forms. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facllitles 8 1 dumpster <br /> All commercial requirements musk meet compUance. <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> '*"PROPERTY SURVEY required for all NEW construction. <br /> Directions: , <br /> Fill out applicaUon completely. , <br /> Owner & Contractor sign back of appllcation, notarized <br /> If over;2500, a Notice of Commencement is required. (AlC upgrades over s5000) <br /> *' � Agent (for the contractor) or Power of Attorney (for the owner} would be someone with notarized letter from owner authorizing same � <br /> � <br /> O TER PERMITTING (Front of ApplicaUon Only) 1 <br /> Reroofs Sewers Service Upgrades A/C Driveways Fences (PIoUSurvey/Footage�.:: ;�_,: <br /> , <br /> " ' `��,� � `m: �_,. <br /> r';� :: x . <br /> �:'�5:`. �'�� : <br />