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s�s-�sa-oozo City of Zephyfiilis Permit Application Fax-813-780-0021 <br /> _ 8uilding Department <br /> Date Received Phone Contact for Permittin 3 ��y� __ �a q,� <br /> fiim �1 � 6uac , �(� ;�l <br /> Owner's Name J ��� V� � Owner Phone Number - � <br /> Owner's Address �� �'OX./'V(,t,�-� �� ��`e�' C p�e�phone Number �— <br /> 3 <br /> Fee Simple Titleholder Name Owner Phone Number --� <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ����OL I,� �� r.� ,.Z� /Z/S�;(/s �f=�/� LOT# � <br /> SUBDIVISION PARCEL ID# i 1-at�-a i�UQ��- �K�� - <br /> (OBTAINED FO pROPERTY T�rice)DEMOLISH <br /> WORK PROPOSED � NEW CONSTR 8 ADD/ALT [� SIGN <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME �] STEEL Q <br /> DESCRIPTION OF WORK � (� ���„ <br /> BUILDING SIZE l,Y SQ FOOTAGE . D�✓ HEIGHT <br /> OBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL a AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C. <br /> �PLUMBING $ ���, o o � h�� <br /> � � � 1 <br /> OMECHANICAL a VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY �] OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER � COMPANY ,g„� � �� c� <br /> SIGNATURE � REGISTERED Y/ N FEE CURREP Y/N <br /> Address ,�3�SJ�' [,f,4 � ,f. -,!/��s Ltcense# �I/`� �y� �ry�p� <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 /> Addreas License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Permit for new construction, <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Sflt Fence installed, <br /> Sanitary FadAtles 8 1 dumpster,Site Wo�lc Permit for subdivisionsAarge 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 constructlon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilitfes&1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet complfance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> """PROPERTY SURVEY required for ali NEW constructlon. <br /> Directions: <br /> Fill out application completely. <br /> Ovmer&Contractor sign back of applicatlon,notarized <br /> If over E2500,a Notice of Commencement Is required. (A!C upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of AppHcation Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurveylFootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />