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s��;�so-�2o City of Zephyrhilis PermitApplication Fax-813-780-0021 <br /> , Bukiing Department <br /> Date Received y �� Phone Corrtactfor Perroitting � ( - <br /> � � � � r � � r <br /> Owner's Name ��c �C q� Owner Phone Number <br /> Owner's Address 9 Z Owner Phone Number <br /> Fee Slmpk Titleholder Name �— � Owner Phone Number �— <br /> Fee Simpk Trtteholder Address <br /> JOB ADDRESS -1Z � �L �3S Z- LOT� � <br /> i <br /> suBav�sioN � PARCEL IDM IZ-2lo-21- �310 -�C7CCp-Ov O <br /> (OBTAINED FROM PROPERNTAX N0710E) <br /> WORKPROPOSED NEwCONSTR ADDlALT � SIGN Q Q DEMOLISH <br /> e INSTALL 8 REPAR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONS'iRUCT10N Q BLOCK Q FRAME � STEEL Q <br /> DESCi�P'110N OF WORK �n Nuc'1CJl �-v����n O Vv C�(�C.�viv.� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> �����G $ -�= VALUATION OFTOTAL CONSTRUCTION L` �'�t,,�V ,� (-1� �� <br /> �ELECTRICAL �� AMPSERVICE Q PROGRESSENERGY Q W_RE.C. <br /> ✓ <br /> ��PLUMBNG $ j Z �� N� �� <br /> � / '� �� ✓� <br /> QMECHANICAL $ VALUAT�N OF MECHANICAL NSTALLAT�ON l � � <br /> � ^ � �� <br /> QGAS Q ROOFING Q SPECIRLTY � OTHER � �f-�SyL(E ��2L� <br /> FYVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � J %,,�y� �,�/J, <br /> ��.5,� �;,yt e!'''C�y�'"`�"''/rv�,``'-' <br /> �.� <br /> _ � � � `-� �c . �h-^��� <br /> BUILDER �,��( C�MPANY S .��_��� <br /> SIGNATl�2E REG6TERED N FEECURR Y/N �.J" <br /> Address p � �C1S1��1�A G 33b`-�� License# �,�5 g3�� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REG6TERED Y/ N FEECURRBs Y/N <br /> Address License# <br /> PLUMBER � COMPANY <br /> SIGNATI�E � REG6TERED YI N FEECURREP Y/N <br /> Address License# (— � <br /> MECHANICAL COMPANY <br /> SIGNATURE REG6TB2ED Y/ N FEECURREM1 Y/N <br /> Address License# <br /> 0T}{� � COMPAM' <br /> SIGNATURE REG6T@7ED Y/ N FEECURRE� YIN <br /> Address License# �— <br /> illllllllllli { IIIIIIItt111t11111111111illlillltllllllllliltlltlllfl <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}workirig days after submittal dafe Reqixred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br />