|
8�s-�so-oo2o City of Zephyrhilis Permit Application !-` ( �/ �� I Fax-813-780-0021
<br /> Building Department � l
<br /> � i.
<br /> Date Received '�
<br /> Phone Contact for Permittin $ � � �j� � �p __ � � �r� ,
<br /> Owner's Name C. �NM9/Q O�FS p �, �? ) ,!d'� � � ,
<br /> Owner Phone Number l � ��,
<br /> 3?7im ! ,
<br /> Owner's Address �SSSO L/ 6/tTwAVF �Yl. �2/0 C[frq,�i✓,��2 Ft pwner Phone Number ��''
<br /> :' ,�;�?
<br /> Fee Simple Titleholder Name Owner Phone Number �..�:
<br /> _' , a
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS � � l yY1 �Q � E/ ,� ;' ✓?� dS� � LOT # ��
<br /> SUBDIVISION ��LpNO f�HR� PARCELID# a3-�G"� °2/- D� 30 - QO C�
<br /> (OBTAINED fROM PROPERTY TAX I�71Cq
<br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN � O DEMOLISH
<br /> INSTALL 8 REPAIR
<br /> PROPOSED USE Q SFR Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL O
<br /> DESCRIPTION OF WORK /Yf W C.ON�ST/'C�1/CTJD/l/ � Tp LG.''/���,yf��r�
<br /> ' ,,
<br /> BUIIDING SIZE SQ FOOTAGE I J� t HElGHT a� '`fTG� �/
<br /> ,3
<br /> QBUILDING $�/, � J�,-p VALUATION OF TOTAL CONSTRUCTION
<br /> DELECTRICAL $ � U � O AMP SERVICE �` PROGRESS EN�RGY a yy� �
<br /> 7
<br /> �PLUMBING $ ���, �
<br /> � MECHANICAL $ � a , r� VALUATION OF MECHANICAL INSTALLATiOh �
<br /> r ��
<br /> �GAS Q ROOFING Q SPECIALTY � OTHE12
<br /> FINISHED FLOOR ELEVATIONS q,c� FLOOD ZONE AREA �YES NO
<br /> 00.
<br /> -*-a--e
<br /> BUILDER � CpMpq�,�y ��N/��� A/��GS
<br /> SIGNATURE REGISTERED Y/ N FEE Cu�h Y/ ry
<br /> Address ,ss$� �1GNTIJA .�/O L FL,,$ 7�0 LiCerase # t. tT C fsi�8 �� ,c'
<br /> ELE�TRICIAN COWIPANY OMOI{/.fQ/�/' �GEC�'?���QJG ,.L1{/'� ;
<br /> SIGNATURE REC,tSTERED Y/ N FEEC�k Y/M �
<br /> Address /D3�f Sx�P f A B, F�C 33G/,� ��� # t�C elp;p ,,�",S' �J
<br /> PLU""R�R CO�ARANY P!�I {N PL.v`,'✓,�/�'}�/ {�' I
<br /> SIGNATURE REGISTERED Y/ N FEE CitRREA Y! N
<br /> A�,�.�� b327 y i � E� (-'a� 3 � � w �'
<br /> Ltcense # ' �s i"� ;� :3: ,
<br /> MEr�-�.,�fCAL COMPANY �Ff aCVrL4�(,'"`l�1iG- �t��Ft'J'lr,'� � �L...-
<br /> SIGt "t'E REGISTERED Y i N FEE CURREI� y/►�
<br /> Ac+drees 1 D•BOX-�.'10$ �/NT L.3h�b'f7 License# LrlC�s�7 t��i0 �.''°� �
<br /> OTu�^ COMPANY � .J17l�j�,(�N(s �AL�i R�JC:I� ,�/(°.
<br /> SIG "^ � REGISTERED Y/ N FEE CURREA Y/ N
<br /> � -5 y��� �SHoA[ �i F Bc.vo SPR�Ne flic.� �c ,3y'� ? �;�, � C"�— � OS ;' � � ' i
<br /> �
<br /> RF ^� � �' L Attach (2) Plot Plans; (2) sets of Buiiding Plans; (1 j set of Energy Forms; R-0.W Permit for raswr constrt�ctipn,
<br /> Minimum ten (10) working days after submittal dats. Required onsite, Constru� P1ar�.s, S6orm�vra�er pfaAS yrd S�t Fence i��
<br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisians/large projects
<br /> COr ^^^ ���� n L Attach (3) complete sets of Building Plans plus a Lffe Safety Page; (1) set of Energy Fortns. R-O-W Penrut tor �exr �.
<br /> Minimum ten (10) worldng days after submittal date. Required onsite, Consinic6on Pfans, g�ortnwater plans w/ S� ��
<br /> Sanitary Facilities 8'! dumpster Site Work Permit for aC new projects. All commercra! requirements must maet cortep�ar�oe
<br /> SI�"� � ^�T Attach (2) sets of Engineered Plans.
<br /> ""PROPERTY SURVEY required for all NEW construction. i
<br /> � ' " J_4 `�
<br /> Dire
<br /> � •,�i���tion completely
<br /> � ,or ractor sign back of application, notanzed �
<br /> ' '���, a Notice of Commencement is required. (A/C upgrades over S7500)
<br /> " ' r thr contractor) or Power of Attomey (for the owner) would be someone with notanzed letter f*om o�nmer authoriz;ng same
<br /> OVE^ OUriTER PERMITTING (Front of Application Only)
<br /> Rem ° �� ,-�!�= Sewers Service Upgrades A/C Fences (PIoVSurvey/Footage�
<br /> �ys-N�t over Counter if on public roadways..needs ROW '
<br />
|