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/. <br /> a�s-�so-oo2o City of Zephyfiills Permit Appiication Fax-813-780-0021 <br /> Building Department <br /> Date Received _ � phone Contact for Permfttin -- <br /> Owner's Name C. 'CC � l �r�s Owner Phone Number � r g�- �� <br /> ''�/ l � <br /> Owner's Address 5�i210 �� � v�—d��'� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number C <br /> Fee Simpte Titleholder Address <br /> JOB ADDRESS -���b � � � ��.X�� LOT A� � <br /> SUBDIVISION � PARCEL IDN 1] � �� `�1 '��� (� ~�C:�]C� - �(.S�' <br /> (OBTNNED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONS7R 8 ADD/ALT Q SIGN Q [� DEMOLISH <br /> INSTALL REPAIR <br /> �.,--.�_ <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q [ � <br /> DESCRIPTION OF WORK 1�.� �� u �C�i <br /> 6UILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ r(� cT�F VALUATION OF TOTAL CONSTRUCTION ��_�._, <br /> �� <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> �GAS � ROOFING Q SPECIALTY [� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � /' J � COMPANY � �.,/��� ��(� n <br /> SIGNATURE �4--L`l �"����- REGISTERED Y/ N FEECURRE� Y/ <br /> Address l� � c�C� � ('� �-L y License# ��-C O J ?�'�Z- <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Add�ess License# C � <br /> PI.UMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address License# C � <br /> OTHER f ��� COMPANY (O,'�� �� - �.1N � <br /> SIGNATURE ��•J -�'i�.� REGISTERED Y/ N FEE CURRE� Y/ <br /> Address 3 / f � License# C C C- n S� 7 � 2--- <br /> RESIDENTIAL Attach(2)Piot 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,ConstrucGon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;S(te Work Permit for subdivisionsllarge projects <br /> COMMERCIAI Attach(3)compiete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pem►it for new constructlon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.Ali commercial requirements 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 application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Noti�ce of Commencement is required. (AlC upgradea over 57500) <br /> " Agent(for the contraCtor)or Power of Attomey(for the owner)would be someone with notarized letter irom owner authorizing same <br /> OVER THE COUNTER PffRMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers SerVice llpg►ades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />