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813-780-0020 City of Zephyrhi Is Permit Application Fax-813-780-0021 ,
<br /> Buildin Department
<br /> Date Received �, Z� 2 V�L.� phone Contact f Permitting ��Z -- v
<br /> Owner's fVame eY r(1 5 11ne �� � Owner Phone Number 'V I _ '-1�15�� - ���
<br /> Oxvner's Address � 1�r, �� • Owrner Phone fdumber
<br /> Fee Simple Titleholder Name Owner Phone Number �
<br /> Fee Simple Titieholder Address
<br /> JOB ADDRESS �J � I -J S� • LOT# �
<br /> SUBDI!lISION PARCEL ID# I 0 " V ' I • O 'V� O ` �Ol(t�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED B NEW CONSTR B ADD/AL Q SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PFtOPOSED USE � SFR Q COMM 0 OTHER
<br /> �PE OF COMSTRUCTIOR9 Q BLOCK Q FRAME Q STEEL Q
<br /> DESCf21PT10N OF WORK �VIr � (�OUY � �QI,C � SI7L_. S�(JL�
<br /> BUILDING SIZE SQ FOOTAGE HEIGH'�
<br /> QBUILDING $ p �B .O O VALUATION F TOTAL CONSTRUCTION
<br /> �,_0
<br /> QELECTRICAL $ AMP SERVIC 0 PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ ��
<br /> QMECHANICAL $ VALUATION F MECHANICAL INSTALLATION J�
<br /> � �
<br /> QGAS Q ROOFING Q SPECIA 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ONE AREA QYES NO
<br /> I
<br /> - Bl91LDER CO PANY --- -- � �� -- --- - -_ - � Y_ _ _ _
<br /> SIGIdATURE REGI TERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAN CO PAMY
<br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> PLURflBER CO PANY
<br /> SIGIdATURE REGI TERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> MiECHAMICAL CO PANY
<br /> SIGRlATURE REGI TERED Y/ N FEE CURRE� Y/N
<br /> Address License# �
<br /> OTHER , 4 CO PANY � �6J V��
<br /> SIGfdAYURE REGI TERED Y/ N F CURRE� Y/N
<br /> Address � . License# C�a o a bR�
<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set o Energy Forms;R-O-W Permit for new construction,
<br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Pians w/Silt Fence installed,
<br /> Sanitary Facflities&�1 dumpster;Site Work Permit for su divisionsAarge projects
<br /> COiMR11ERCIAL Attach(3)complete sets of Building Plans plus a Life Sa ty Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit for all ew proJects.All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans.
<br /> "'""PROPERTY SURVEY requlred for all NEW construc on.
<br /> Directions:
<br /> Fill out application completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> tf over b2500,a Notice,of Commencement Is required. (A/C upgra es over�7500)
<br /> # .�.,_,�,:�.,� , �"-.n,.r�e,�_:r.._:...,....:e..i...,u,.... _.._�,..,.,.k.�,;..•�.,..,:a
<br /> •' Agent(for the contractqr)or Power df'Attomey(for,the.owner)vi{ould be someone wlth notarized Igtter from ownef,�authorizing same�:��.,, �
<br /> OVER THE COUNTER PEF�MITTING�� �',�:}(Front'of;AppliCationtOnty) � . n; ` � '_^��;•r`�`.�f � _`; `
<br /> •; " .�;':�,;i,., �, ,
<br /> Reroofs if shingles Sev�ers._. ,.,;�.,,�Seniice'Upgrades�•A,/C��4�`�`��Fences( IoUSurvey/Footage) � _. :`;'""r -','"','"'`�` "
<br /> .. .. � .�,, s. � . • s;; ,.i ^• -.,..-, ��:;.�',• .�' �
<br /> •'�*'i+�.e'rr.u_C.lo, v...-�M.fnt-x• .+.tn-�oK�..e wn .�g��� �•rs9.saiai.•.va �:Q-i_v�frt raaW,F�.. Knv�`.�•�om-.ua+w�:xrNf±;
<br /> Driveways-Not over Counter if on public roadways..needs ROW
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