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s�s-�so-oozo City of Zephyfiilis Permit Application Fax-813-780.0021 <br /> Building Department <br /> Date Received �, � Y <br /> � Phone Contact for Permittin <br /> Owner's Name e�-i J�e w('�s OwrJ�f phone Number 'l ' <br /> Owner's Address Z 26 �a S �� '�` ���� � _ <br /> �" � Owner Phone Number 3 ` —.�sZ <br /> Fee Simple Titleholder Name JJ d ��d,,,`�--�� � p�er Phone Number <br /> Fee Simple Titleholder Addresa b Z � � ��f�' —{� � � �,.��� �� �� s' Z <br /> JOB ADDRE3S b Z ZO !�� "�"Z� ' I .3.3,5�2, LOT# Z � <br /> SUBDIVISION o w� �V � PARCEL ID11 C�Z'�� - Z/- O O F'Td- aazaa ' b Z$Q <br /> (OBTAtNED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK l /f��d� � Q <br /> BUILDING SIZE �g� ZQ� SQ FOOTAGE 3 6 O HEIGHT ( � <br /> OBUILDING $ /� �� /,� VALUATION OF TOTAL CONSTRUCTION <br /> 7(,J <br /> QELECTRICAL $ AMP SERVICE p G <br /> Q �E9��fNERGY Q W.R.�„G.._,__..�_ <br /> /J�l�, t..�,,�",r,�'��7 L l � <br /> QPLUMBING $ �,/ �� <br /> QMECHANICAL a VALUATION OF MECH AL INSTALLATION (3 � �� <br /> � <br /> [�GAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER ' COMPANY � <br /> SIGNATURE � t' REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <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# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy FoRns;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 Facilitles&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Buildfng 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 submlttal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpste�.Site Work Permit for all new proJects.All commercial requiremenfs must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""'PROPERTY SURVEY required for all NEW constructlon. <br /> Directions: � � <br /> Fill out applicatfon completely. <br /> Owner&Contractor sign back of appiicaUon,notarized ` ' <br /> If over i2500,a Notice of Commencement(a 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 authqrizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) • ' <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />