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$��-�� City of Zephyrttills Permit Application JL Fax�13780-0021
<br /> Building Departmerrt �� � �`
<br /> � �J�Dt���� -��7 �
<br /> Date Received ��` — Phone Contact for Permittin ��� a y3 - a�a 6
<br /> Owners Name '�' �(.i.S�G•,,,(��^� �'> > Owner Phone Number
<br /> Owner's Address , � n� �ol � �✓' �,�t1jG �ry Owner Phone Number �—
<br /> Fee Simple Titlehokler Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOBADDRESS S��G 7� S�, LOT# rnG��� ,,��
<br /> SUBDIVISION (--/� ���,� �( I�,j�S PARCEL ID# —��",��—�J���'—����,G�� '��"����
<br /> (OBTAIN�FROM PROPB2TY TAX NOTIC�
<br /> WORK PROPOSED B NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE � SFR COMM � OTHER
<br /> TYPE OF CONSTRUCTION � BIOCK � FRAME � STEEL �
<br /> �,/` 1L �V/ �J� J''�
<br /> DESCRIPTION OF WORK S�' ',1,,' /=�) l� I��L� —�C�(.J tfc� �'�>� r�G{r�
<br /> BUILDING SI� SQ FOOTA�GE _S/ HEIGHT
<br /> QBUILDING a�i ���� VALUATION OF TOTAL CANSTRUCTION
<br /> QELECTRICAL $ P SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ � �l�� / /•12�<.�+ ������_ �
<br /> � �
<br /> QMECNANICAL $ f �J�D,GV VAIUATION OF MECHANICAL INSTALLATION
<br /> f� /
<br /> �GAS � ROOFING � SPECIALTY � OTHER
<br /> FINISHED FLO�R ELEVATIONS FLOOD ZONE AREA �YES NO
<br /> / �
<br /> BUILDER ' / /�i�, ,�j (ll��� COMPANY ��U�/�'..1�77` �FJ,V?'�,+';✓"�✓r✓,^-",7'�7,.�I��-
<br /> SIGNATURE ��i/ ic� '� REGISTER@ / N FEECURRBJ Y/N
<br /> Address 'rU 1�.� l�.�w' " ���/ License# ��� ,' �'J�
<br /> ELECTRICIAN /� _� �. COMPANY Ol'�P L�LPL�1 �LC
<br /> SIGNATURE �r��.- REGISi92m Y N FEE CURREN Y/N
<br /> l�ddress ��4 7 GjAC"/�/yJi¢ili�%�A �.Sv�,�a0� ��t fet,�L, l.icense# C/��3(i�7�.5� i
<br /> SIG ATURE �'F(/I I�/,✓,✓t �,� �NJ COMPANY ' �/�.�`����p/ T�G`�
<br /> REG�STER� N FEE CURREN Y/N
<br /> Address I��� t' � p '.(a� U� k� ' , ��i� ��S� License# C � y `7
<br /> �` � /�' l,,� /� `'�
<br /> MECHANICAL C/�, . � �if COMPANY (/N /1!`L /7/�P CC.'NA/�dy1//Y'�
<br /> SIGNATURE %`"'���� REGISTB2m N FEECURRHJ Y/N
<br /> Address 36� ��iuQGV (,./-�- /�,�/ ,/`� �� License# �� C � �j� / D
<br /> 1
<br /> O1HER �C�l � ���� COMPANY � ✓P �L '/�Il'J�! �i `C .,�.
<br /> SIGNATURE � REGISf62m / N FEE CURREN Y/N
<br /> A[IdreSS �f 5�� ` "jl ��/�� Z � �} LiCense# 1..�Cr C_ � / (� /
<br /> IIIIIIIIf1111I I / IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIflllllllllll
<br /> RESIDENTIAL Attach(2)P�t Plans;(2)sets of B�rlding Plans;(1)set of Energy Forms;R-0-W Permit for new cor�Luction,
<br /> Minimum ten(10)worldng days atber submittal date. Required onsibe,Construction Plans,Stomrwater Plans w/SiR Fence installed,
<br /> Sanitary Facilities 8 1 d�xnpster,Site Woric Pertnit for subdivisions/large Prolects
<br /> COMMERCIAL Attach(3)complete s�s of Bulding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new construction.
<br /> Minimum ten(10)w�orldng days aRer submittal date. Required onsite,Construction plans,Stortrnrater Plans w/Sik Fence installed,
<br /> Sanitary Fadlities&1 dtmpster.Site Work Pertnit for alI new projects.AII commercial requiremerts must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans.
<br /> ""PROPERTY SURVEY required for all NEW constn�ction.
<br /> Directrons.•
<br /> F!I out application completely
<br /> Owner&Contractor sign back of application,notarized
<br /> If over 52500,a Notice of Canmencement is required. (A/C upgrades over 57500)
<br /> " Age�t(for the contractor)or Power of Attomey(for the owner)vwutd be someone with rqtarized letter from owner aWiorizing same
<br /> OVER THE COUNTER PERMITTING (Frorrt of Application Only)
<br /> Reroofs if shingles Sewers Servic.�e Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Driveways-Not over Courrter if on puaic roadvrays..needs ROW
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