|
813-780-G020 City of Zephyrhilis Permit Application �� �jI /�Fax-813-780-0021
<br /> Building Department
<br /> Date Received $ i � � � � _. � � ��
<br /> Phone Contact for Permittin
<br /> Owner's Name �����,\ �/�ES Owner Phone Nurtaber �,��c ,��.� "��� ° ,�''T�O ��'
<br /> Owner's Address �555� �/ 61iTwA✓E 1Y1. �2l� C[E' 3?7Lo � ';'�.. ;�
<br /> ���� �- Owner Phone Number {' "
<br /> Fee Simple Titleholder Name � ; i '�� i #
<br /> Owner Pho�e NumbE:r
<br /> i
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ��l.P T �� �'Vl �Y��/ I c�+'1-e_ZE�,N�/R:� �: �L� •� 'S 'j�?`' /"� I UO
<br /> � LOT #
<br /> SUBDIVISION ���-pNp PAIQ/�. PARCEL ID# �.l ' �� ""Z`" D,2 � �) – UQ� – I �
<br /> � (OBTAINED � PRpPERTY T � itC� DEMOIISIi
<br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN L _�
<br /> INSTALL 8 REPAIR
<br /> PROPOSED USE Q SFR � COMM � OTHER
<br /> TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL O r
<br /> DESCRlPTION OF WORK /V � W LONcS'T' r i (�1/t,/ ° -Y– Tp (,�,,r�l,.'y0�► ,�.
<br /> �
<br /> BUILDING SIZE SQ FOOTAGE 1��O HEIGHT C�Ta� �'
<br /> TTrrr'�7T
<br /> �BUILDING $ 31, G5o VALUATION OF TOTAL CONSTRUCT{ON
<br /> �ELECTRICAL $ AMP SERVICE � PRpGRESS EtVERGY � �t ;��, �
<br /> � ��� " 'r
<br /> �PLURIBINU $ ���� �
<br /> MECHANICAL , ''
<br /> O $ r,� ��� VAWATION OF MECHANlCAL INSTALLAT O�
<br /> 7
<br /> �GAS � ROOFING � SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS Q�� � FIOOD ZONE AREA OYES NO
<br /> 0
<br /> �-�--F..�..a.._�...�._.t..
<br /> BUILDER / COMPANY �E��9� l71�J��S
<br /> SIGNATURE / REGISTERED Y/ N FEE (� y/�
<br /> Address �SS$V �tLNfl+/A .�JD �LflyiQl✓.9'TE�� �"1.,,� 7l�' LiCenSe # ��T C- /�Si�� r ,�; ;
<br /> ELE�TRICIAN COMPANY DM0�1/fQ/�f G L,ECT,%Q/�. ..1�,r' [, ?
<br /> SIGN�Tt1RE REC,ISTERED Y/ N �c�a YtN
<br /> Address ��37 Jl�1P� 0 � � , f� �3G/ —�
<br /> .�1 License # �C �G>t7� �$'f �1' I
<br /> nnnc � �
<br /> PLU R COMPANY B�N IN P�.�'+'�1J�j r ;
<br /> SIGNATURE REGISTERED Y/ N f'EE CURi�h Y;{�
<br /> A�f-����4 6.3�� H �� YlEMI �i.� .3 L;cense � � ._ " �- ,` n,' �- f ��'"
<br /> MEr 'ICAI � �- .r � � ��
<br /> COMPANY ti'�,� ?,�,t :° : rz� �� >'�`� s�` �,(_,', f
<br /> SIG� "" E REGISTEREO Yr N =EECJRf2Er ��
<br /> p ,iF �,.
<br /> A''''re�s /-• D• L7DX �.30 D NFl TONVT L.3��►7�+/'f License # t. � r� 0� +t"�' j0
<br /> SIGNt�n COMPANY C .S'�,rr�,�►N6 �,r,�t � ; � ''1A�.}�. ,��,�+�
<br /> �� REGISTERED Y/ N FEE CURREA Y f N
<br /> � _ y�ll.sNoAl �rNF �c.vo SPR�+v4 �/ic,� tt �y'i� 'J License # ����- � D$" � � ,f ,
<br /> i11111111111111111111111111111111111111
<br /> R�"' '" L Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit far r�ew cortstruction.
<br /> Minimum ten (10) working days after submittal date. Required onsite, C�struction P1ar�s, gtortnwater ppans �n,� � F� ir�d,
<br /> Sanitary FaciliHes & 1 dumpster; Site Work Permit for subdivisions/iarge proj�cts
<br /> COr^ ^� �^�� n L Attach 3 com lete sets of Buildin Ptans lu� a L'rfe Sa�e ra e; 1 set o# E
<br /> () P 9 P tY � 9 () nergy Forms. R-0-W P�mit for ruew construction.
<br /> Miriimum ten (10) working days after submittal date. Required onsite, Construction Plans, gtorrrwrater �larss wy � F� �
<br /> Sanitary Facilities 8 1 dumpster. SRe Work Permit for all new projects. Ail commer�ial requir+arr�etqs must �et �
<br /> Si�" " "T Attach (2) sets of Engineered Plans.
<br /> '*"PROPERTY SURVEY required for all NEW construction.
<br /> �I..1• ° �-1–
<br /> Dire
<br /> � ��ni�r�tion completely
<br /> 'o�" ractor sign back of application, notarized
<br /> '���, a Notice of Commencement is required. (A/C upgrades over 57500)
<br /> " r th� contractor) or Power of Attomey (for the owner) would be someone with notarized letter'rom owner auth�rizing same
<br /> OVE^ �I.lnlTER PERMITTING (Front of Application Only)
<br /> Rerr r�-�i--= Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage)
<br /> : �„
<br /> �
<br /> �ys-N�t over Counter if on public roadways..needs ROW �
<br /> d.,,
<br /> . ��
<br />
|