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s�s-�8o-002o City of Zephyrhi6ls �ermit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received '� ���� 2� _ � � <br /> �'" Phone Contact for Permittin - <br /> 1 <br /> Owner's Name � c� = C ��� � Owner Phone Number <br /> Owner's Address � � , � ��-� � � J� Z' �'`-� � Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# C� <br /> SUBDIVISION � PARCEL ID� `'� ' 2 5 �� - C�I 6 r_�pt�o � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADDlALT 0 SIGN Q �� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK � �6 i ! �%t-�� t°� jIZ � �') �''7 f I`6 c� <br /> BUILDING SIZE �- SQ FOOTAGE� HEIGHT ] <br /> QBUILDING $ [� �'.c'- VALUATION OF TOTAL CONSTRUCTION <br /> �J ��C,; <br /> DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.0 <br /> QPLUMBING $ � � ����P`� <br /> � `/ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � ` ��� � COMPANY �C- ��� '� � <br /> SIGNATURE '"�-�- � REGISTERED Y/ N FEE CURRE� Y J N <br /> Address '/ / ( � �i- � �, ! j 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# C <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> Address License# � <br /> OTHER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructfon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles 8 1 dumpster;Site Work Permit for subdivisfonsRarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.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 Facilities&1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for ail NEW consVucUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of applfcatlon,notartzed <br /> If over 52500,a Notice of Commencement ia required. (AIC upgrades over 57500) <br /> •• Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application 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 />