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�-,rr�u-vozU City of Zephyr ills Permit Application Fax-813-780-0021 <br /> Buil ing Department <br /> Date Received Phone Contact f Permittin -- <br /> Owner's IVame 4�'""� (�/'�.— � Ovdner Phone Number <br /> � � <br /> i <br /> OwnePs Address � P o Number <br /> IFee Semple Titleholder Na , � Ovener Phone Number <br /> Fee Simple Titleholder�ddress <br /> JOB ACIDRESS y L07# � <br /> __ _SUBDlYtStON - -� _ �- -�PARC 1.:-ID# -- ___ --_ --- --- --- <br /> (pBTA1NEp FROM PROPERTY TAX NOTICE) <br /> WQR1C PitQPOSED e NEW CO�tSTR 8 ADDlA T � SIGN Q Q t7EMO�ISti <br /> iNSTALL REPA( <br /> PROPOSED USE • � Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q CK Q M � S7EEL Q <br /> DESCRtF�TtON OF VNOR4C <br /> BUILDING SIZE �Q FO TAG FiE1GHT ��� <br /> QBUtLDiNG � VA�UATtO OF TOTAk.CONSTRUCTION <br /> QELECTRICAL $ AMP SERV CE 0 PROGRE3S ENERGY � W.R.E.C. <br />, �PLUMBtNG ($�� <br /> �_ � � <br /> QMECHANlCA� $ VALUATIO aF MECHANICAL INSTRLLATiai� � � <br /> , � 1 <br /> � iV <br /> QGAS Q ROQFING Q SPECI LN 0 OTHER . �� <br /> �� (�'�QQ i� <br /> FINISHED FLOQR ELEVATIONS � FLOO ZONE AFtEA [�YES NO ��'"" <br /> � <br /> "'f <br /> BUiLD�lt G MPd�NY <br /> I SIGNATt7RE RE ISTERED Y J N FEE CURRE� Y/(�l <br /> Address License# � � <br /> ELEC'iR1ClAM G MPANY <br /> SIGNATUFtE RE IS'TERED Y/ N FEE CURRE� Y/N <br /> Address Lfcense# � � <br /> P�.U1I+IBER � C MPANY <br /> 1 <br /> 51GNATURE RE IS7ERED Y/ N FEE CURRE� Y/N <br /> Address Ltcense# C � <br /> MEGliAN1CAL � C Mt�ANY <br /> 51GNATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Addtess icense# <br /> OTHER C MPANII <br /> SiGNATUR RE IS7ERED Y RI FE CURR t+ Y�N <br /> Address '� �icense# r� � <br /> RESIDENTtAL Attach(2}Plot Plans;(2)sets of Building Plans;(1)set f Energy Farms;R-O-W PeRr►it fae new canstruckion, <br /> Minimum ten(10}working days after submi##ai dafe. Ft quired onsite,Construction Ptans,Stormwater Plans wl Sfit Fence instaEted, <br /> Sanitary Facilltles&1 dumpster,Site Wark Permit for bdivisions/large projects <br /> COtNlMEFtC1AL Attach(3}comptete sets of BuHding Pians pius a Life S fety Page;{1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minlmum ten(10}working days after submi#tai date. R quired onsite,Constructian Pians,Stormwater Plans w/Siit Fence instaUed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit far II new proJects.All commercial requirements must meet campliance <br /> SIGN PERM17 Attach{2)sets of Engineered Plans. <br /> •••'PROPER"TY SURVEY requlred 1or ati NEW constru tion. <br /> �ireetlons: <br /> Filt out application completely. <br /> Owner&Contractor sign back of application,notarixed <br /> If aver 52500,a Notice of Commencement Is requlred. {JUC apg des over�7500} <br /> •' Agent(for the contractor)or Power af Attomey(for the owner)would e someone with notarized letter from owner authorizing same <br /> OVER THE COUNTE#2 FERMI7TIN� {Front of Appiication Only) <br /> I Reroofs if shingles �ewers Service Upgrades A/C Fences(Piat/Survey/Footage) <br /> Driveways-Not over Counter if an public roadways..needs ROW <br />