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a�s-�ao-oo2o City of Zephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Rec.eive� <br /> Phone Con4acQ 4or Permittin� -- <br /> Ouvner°s�aene �� �G�' OvNner�hone Mumber �/� Z�! <br /> �nrner's�+ddress � b�� � Owm�r Phone�lumber <br /> Fee Simple Yitleholder Rl�ime � O�nrn�r�hone P�umber —� <br /> Fce Simple T'.a,lehoider�ddress <br /> .DO�c��D6dESS v lO� l lo� S LOT# � <br />- SUBD6l49SlOM -- - �ARCEL ID# > - - - - - -- --- <br /> (OBTAIMED FROM PROPERTY TAX MOTICE) <br /> HIfOREt�ROPOSED e NEW CONSTR e ADD/ALT � SIGN 0 Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOS�Dl6SE Q SFR Q COMM � OTHER <br /> TV�E,OF COMSTRUCTIO� Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPYIOfd OFlAl06t� ' (�y.f' �i� � <br /> � � <br />'i �UIL�GRi¢°s SI�E —� FOOT�,GE �I I��Ots'FCY � <br /> OBUILDING $ l 75 Q� VALUATION OF TOTAL CONSTRUCTION <br /> 6 / <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY 0 W.R.E.C. <br /> OPLUMBING $ <br /> � �5���� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATIOM � <br /> OGAS Q ROOFIfVG Q SPECIALT`( 0 OTHER <br /> FIMISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO `'���� <br /> �uiL��� Cavi P ��1 l� co���,�v � �� ��'I�e <br /> SIGi�.4TURE REGISTERED Y/ I�I FEE CURRE� Y/RI <br /> �,ddress S��U —�c S Pa � License# � <�S+ <br /> ELECYPt9CIAl� �p��q�y <br /> SIGR1.4Tfl16tE REGISTERED Y/ N FEE CURRE� Y/N <br /> Ac9dress License# <br /> PLUfNi��R COflflPA�IV <br /> ��G������ REGISTERED Y/ N FEE CURRE� Y/�V <br /> �ddress License# <br /> MECH�9fUICAL COfNi�e�ii�lY <br /> SICzR1�e��DRE, REGISTERED Y/ IV FEE CURRE� Y/N <br /> �►ddress License# <br /> OTI�EEd COMPAINY <br /> SIGR�e��TU�� REGISTERED Y/ N FEE CURREfi Y/N <br /> Address License# <br /> 92ESIDEW�IAL 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,Construction Plans,Stormwater Plans w/Silt Fence instalied, <br /> Sanitary Facilitles 8 1 dumpster;Site Work Permit for subdivisions/large projects <br /> COflAfIfI�FTC6�,L Attach(3)complete sets of Build(ng Plans plus a Life Safety Page;(1)se4 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 8�1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGId PERRAIT Attach(2)sets of Engineered Plans. <br /> O�ROPROPERTY SURVEY required for ali NEW construction. <br /> 9irec6lons: <br /> Fill out application completely. <br />� Owner&Contractor sign back of application,notarized <br /> If ovee�a500,a Wotice og Commencement Is required. (RJC upgrades over�7300) <br /> *' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> ONEFt THE COURlTER PERiiflITTIRIG (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Drivevuays-Not over Counter if on public roadways..needs ROW _ <br />� . <br />