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813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> r <br /> Date Received Phone Contact for Permitting ��3 �'g�. __ �� <br /> Owner's Name �rK.Q� r�p�e�s Owner Phone Number g/ J <br /> Owner's Address Owner Phone Number C <br /> Fee Simple Titleholder Name �' Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ���3 LOT# �� <br /> SUBDIVISION f 911 �� S d , PARCEL ID# Oe�`a L'1/' 00�( - Q7J`?)D -1)D D <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT 0 SIGN Q �� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK Q FRAME � STEEL Q � <br /> DESCRIPTION OF WORK `s y3 Q S�t/1�t�Q�, �•/�,��� <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> �BUILDING $ 663 $� VALUATIONOFTOTALCONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OP�UMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> �GAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY �G�� �C.� ��p� ��p <br /> SIGNATURE REGISTERED Y/ N F CURRE� Y!N <br /> Address �tI � License# e C G S 8/,3� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � -� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy FoRns;R-O-W Permit for new construction, <br /> Minlmum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instatled, <br /> Sanitary Facilities& 1 dumpster;Site Work Permit for subdivisionsflarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(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 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. ' <br /> '"•*PROPERTY SURVEY required for all NEW construction. <br /> , <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized �"~""�"^°�"• � �*..ia.,,,�wo„a,,, �_ <br /> .9tt..�t:. <br /> If over E2500,a�[�J;q�,�o nmencement is required. (A!C upgrades over 500) > , , . , '$" <br /> �w3 .�u ..., <br /> " Agert(for the c tracto�).qr P�ower of Atto�mey .. would be someone 'th notariied'f�9tter�froh�c�Nnerau�horizing s�e <br /> .�Ft�x a;-,��,;t,� '_ � �, <br /> OVER THE COUNT ��PERMITFING , (Front of Ap�jF'ca�qq ly) \, r � <br /> Reroofs if shin les �'Sewers '�„ � . �' �"�� <br /> 9 -,Sentlq�,Upgrades� � Fences(PIoUSurve Foota e) �"�;'�',� <br /> tr '•tt;"7r;p' �°•^ °�• : '�n.. <br /> Driveways-No 'f on ublic roadways..needs W <br /> :,�. <br />