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ei3�aaoozo City of Zephyfiilis Permit Application Fax-813-780-0p21 <br /> 6uilding Deparlme�l �� �/ <br /> ���� �\� DateReceived - 2r-�Z �� O� _ �l/{�� <br /> �� � Phone CorMact(or Pertnittlng <br /> n �y 'L � _ <br />�- .���` OwneYs Name � ( ��1- . �h '� `�'� J (�il�'i��r � '�.�7 pWner Phone Number <br /> �� Owner's Address �i ` � � �� ( i� K 1(?f�, ,f) pw�er Phone Numbar� <br /> F e e S i m p l e T i U e h o l der Name Owner phone Number� <br /> Fea Simple Trtleholder Add►ess <br /> JOB ADpRES3 <br /> �-�",- I I' � �� <br /> LOT# <br /> 3UBDIVISION PARCEL IO�k -��",�� , �f� ���`, (`C��� �� � <br /> � (OBTAINED FROM TAX NOTCE) <br /> WORK PROP03ED NEW CONSTR B qpD/qLT � SIGN MOVE q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR y� COMM � OTHER '�—'---� <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME � STEEL � OTWER yti; �-� <br /> DESCRIPTION OF WORK y!� T-Q�(�as .��cXi,�,y L1 -��� S S�' V- Y w�+IC ) �GL ��/� � <br /> �' � � �(L!o'S• f� �P./,t-t-J►`Yr-.G <br /> , , L/? �y�� ,p <br /> BUILDING SIZE D'�i (� a� SQ FOOTAGE 7 J(��,�Q HEIGHT <br /> �� BUILDING $ ^� <br /> d (kJ O •C)C7 VALUATION OF TOTAL CONSTRUCTION <br /> d ELECTRICAL $ �AN�p SERVICE � PROGRESS ENERGY � <br /> W.R.E.C. <br /> Q PLUMBING $ <br /> 1� � ��t`'S j.�l�-� � <br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � C�oti <br /> 7" '( (11i'"`�� ��v <br /> Q GAS � ROOFING � SPECIALTY � OTHER �` `� ( ����('��� <br /> FINISHED FLOOR ELEVATIONS � ��� � <br /> FLOOD ZONE AREA �yEg �O �Q1 <br /> BUILDER yt��l�- Cpp�PANY — <br /> SIGNATURE �L ��5�� <br /> / N FEE CURREM Y/N <br /> Address ' � -_,,� <br /> � Lioense# <br /> ELECTRICIAN / COMPANY S N�C }1. S� � ) � <br /> SIGNATURE l REGISTERED y nJ <br /> FEE CURRENT Y/N � <br /> Address � �T l.�:1 �ow 2� C �L /� <br /> , 31� nSe# I-l.�' D()(7 j I "7� <br /> PLUMBER COMPANY <br /> SIGNATURE Rec�s�o Y/N FEE CURRENT Y/N� <br /> Address �� <br /> License# <br /> MECHANICAL COMPANY � <br /> SIGNATURE REG�sTERED Y/N FEe CuRREr�T Y/N <br /> Address � <br /> License�R � <br /> � � � <br /> OTHER C�PA� <br /> SIGNATURE rtEC,�sTEREO Y/ N <br /> �E cuw�kr Y/N <br /> Atldress <br /> Llcenae# �� <br /> -_J <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bufiding Plana;(1)set of Enerpy Fortris;R-O-W Pertntt for new construction. <br /> Minimum ten(10)waking days aftRer supmitte�dat�. R�yw��y�,�nstruction Plans,Stamwater p�ans w/Sift Fence insfelled, <br /> Sanitary Fadlfies&1 dumpster,Site WbAc Permit for subdivisionsJlarge Projecis <br /> COMMERCIAL Attsc1�(3)mmplete sets of 8�1�d�g plans plus a Ufe Safety Page;(1)s�of Enerpy Forms.R-O-W Pertnft for new construcNon, <br /> Minimum ten(10)wariciny days after submittal date. Required onsite,Constructioo Plans,Stormwater Plans w/Silt Fence instaNed, <br /> Sanitary FaciliUes d 1 dumpster.Site V�b�1c PermR for all�ew Projects.All commercial reyuireme�ts must meet cqnpliance <br /> SIGN PERMIT Attach(2)yete of Engineered Plans. <br /> ""'PROPERTY SURVEY reqWred for all NEW consVudion. <br /> Directions: <br /> FiN out applicaBOn completely <br /> Owner&Contractor sign back of application,notarized <br /> H over S25p0,a Notlee M Commencement is requirad. (A/C upgrades over 45000) <br /> " Apent(for the contraqor)or Power o{qhomey(for fhe owner)wouW be aomeone with notarized letter from owner euthorizing same <br /> OVER THE COUNTER PERMIT7ING (Front of Application Only) <br /> R�O°� S�e�$ Service Upgrades A/C Fences(PIOUSurvey/Footage) <br /> DrlvawaysNot over Counter A on public roadways..needs ROW <br />