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e�aaao-oozo City of Zephyrhilis Permit Application Fax-813780-0021 <br /> �9� <br /> Date ReceWed G� — I Q ° �� Phon�GorMad for Parm�n� �� 1 ��`►' — �I <br /> � � ■ � � � _ � � <br /> Owners Name G/-� ��fYl l Li�,�— Orner Plane Numbv <br /> ��.,�� 31 �33 �ul v.� �.�.��.. 8i3—�i�'i�—�tc�3� <br /> Pee Simple Titlsholdar Name � ��P��»�^� � � <br /> Fee Simple TitleAolder Address � <br /> JOB ADDRESS �� (J�� �U-J'(�-v�I �J�" '�h f h(�( � LOT 0 C� <br /> SUBDNISION PARCEL ID/ <br /> (oerwwEO rwar neoreen r�wrrt� � <br /> WORK PROPOSED e NEW CONSTa 8 ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER �t � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q � <br /> �/� �' � cJ � , � <br /> DES(:f2Y+T10N OF YYORK Y� �� � � n <br /> BUII,AIN6 SIZE �— SQ FOOTAGE� HEIGHT � <br /> � � � � � � ■ ��� � ■ � � � ■ � ■ ■ � � � � � � � � � � � � � � / • � � � � � � � � � � � � t � � <br /> BUILDI,,.NS'a.�' S• VALUATION OF TOTAL CONSTRUCTION <br /> �-�-- a,cx�.�. <br /> �ELECTRICAL � AMF SERVICE Q PROGRESS ENERGV Q W.R.E.C. <br /> OPLUMBWG � (��/�' / <br /> �MECHANICAL S VALUATION OF MECHANICAL INSTAL TION � ���� ` <br /> � A(� <br /> �GAS Q ROOFING Q SPECIALTY � OT ^ �Iw <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE ARF�,.��I� 4� NO <br /> ., �� <br /> Jj�BUILDER �MP `e(''� � �0�.-C.�l�i(+T C- �11' _Y'`�' <br /> �g�A !N �ct�n Y I N <br /> � d- r. E ���� R �`� i� 35 <br /> ELECTWGAN � � C�OM�?� � ��A y'N <br /> 516NATINiE � <br /> Addrecs License# � <br /> PLUMBER COMPANY � <br /> SiGNATURE r�d57ExE0 Y/N ceE Ctux�n Y I N <br /> Address License#� � <br /> MECHANICAL COMPAHY <br /> glpNpTURE �c�s��o Y/N �cuaaEn Y/N <br /> Addresa License# � <br /> OTHER � COMPANY � <br /> SICaNpTURE REas7EaED Y/N FEE Cur�n Y!N <br /> Addreu License ii <br /> RESIDEN7IAL AUach(2)Plot Plans;(2)sels of 8uilding Plans;(1)set of Energy Forms;R-O-W Permit fw new constiudion, <br /> Minimum ten(70)worldng days aRer submittal date. RequNed onska,Constrvcdon Plans,Stamwater Plans w!Silt Fence installed, <br /> Sankery Facitltles 6 1 dum�ter,Ske Waic Pertnit for subdNicfor�sAe�ga pojeds <br /> COMMERCIAL Attach(3)compbte sets d Building Plans plus a L'rfe Safdy Page;(1)set of Energy Fortns.R-O-W Permft for new co�sW dion. <br /> Minlmum ten(10)working days aRer submiltal date. Required onsile,Constructlon Plana,Slormwater Plans w!Silt Fence installed, <br /> Sanitary Far�ities d 1 dtxnpcter.Sife Wak Permit fw atl new pro�cla.Atl canmercial requlrerner�ts must meat compliance <br /> SIGN PERMR Attach(2)sets of Engineared Poans. <br /> •'°PROPERTY SURVEY required for a�l NEW consWctlon. <br /> � 1 / � � � 1 � � � � � 1 � 1 � � � 1 ! � � � � � � i � � 1 � t � � � / � � � 1 � � � � � � � � � � <br /> Wrectlona: <br /> Rd out applicatlo�completdy. <br /> Owner 8 ConVactw sign back of applieation,notarized <br /> M evr f2509.a MeNa d CawmMO�rnt Is�sqWnd. (A!C upgrad�s owr t75�) <br /> •• qgent(for the conVac[or)w Power ot Attomey(fw the owner)waid be someone wiM ndarizad letter/rom owner authorizing same <br /> OVER THE CWNTER PERMIT'TING (Front of Application Only) <br /> Reroofs H shingbs Sexera Sarviee Upgrades A!C Fences(PlotlSurvey/FOOtape) <br /> OrAre�rays�Nai over Camter if on pibNC roadvays..needs ROW <br />