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a�saeo-oozo City of Zephyrhilis Permit Application Fax-813-780.0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin - <br /> Owner's Mame - c{� rc,s Owner Phone Number ��3- -7$ -L,�{.`dCo <br />' Owner's Address 5 33`i �.'1-�k �l.�S� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ���T rn� LOT# � <br /> SUBDINISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B N TALLS7R e REPAIR � SIGN Q [� DEMOLISH <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> NPE OF CONSTRUCTIOId Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK� �LS� � ���C!, �� ���- <br /> BUILDING SI�E---. _ �@�A6E----��._ HEIGHT <br /> �BUILDING °� $ VALUATION OF TOTAL CONSTRUCTION �1a�- d'JS� ��'"�1 <br /> 1 � � 2S_____ <br /> ______--- --- <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION r _ � � , �J,V <br /> V <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER � <br /> � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDEit ��OMPAIdY �� C�3�,.1�-�ear <br /> SIGfdATURE L�,MC REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAM COMPANY <br /> SIGMATURE 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# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> - $IGkA►Tb1RE -� ---- �- - -- - REGISTERED �- -• -Y/ N FEECURRE� -�Y-/N'- - --- -' <br /> Address License# <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)worfcing days after submittal date. Required onsite,Construction Plans,Stotmwater Plans w/Silt Fence installed, <br /> Sanitary Faciiitles 81 dumpster,Stte Work Permft for subdivlsionsAarge projects <br /> COMiNERCIAL 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. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciUties 8 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 all NEW construcUon. <br /> Directions: � <br /> Fill out application completely. <br /> Ovmer 8�Contractor sign back of application,notarized <br /> If aver 52500,a Notice of Commencement is required. (AIC upgrades over ST500) <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�, • ,''(Fr'ont of�Application.Only) '" -' _ ._ _. . _ <br /> Reroofs if shingles Sewers �� � Seivice;Upgrades.A/G ;- :Fences(PlobSurvey/Footage) ' �" �-' =' .�. _.: _ _ : . <br /> � � , .;�:�-. .. _ - . ' � • ,- . . - . _ - <br /> Driveways-Nat over Counter.if on.pu6lic roadways..needs ROW � � • " • . ,_ ,,, '' ' <br /> - -�- -�--•_.,_�__,_ , <br />� <br />