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ais-�eo-oozo City of Zephyrhi Is Permit Application Fax-813-780-0021 <br /> Buildi g Department <br /> Date Received ��,3 7�s q�3 �j/ <br /> Phone Contact i r Permittln -- <br /> Ou►ner's Mame P�o�L �6�2�ti r� �c' ' Owner Phone Mumber <br /> O�nmer's Address S 73 � �2£SS s � Oevner Phone Number <br /> Fee Sirnple Titleholder Name Oevner Phone Number <br /> Fe�.Simple Titleholder Address <br /> . �JOB ADDRESS S A N�l f. LOT!t <br /> SUBDI!/ISION PARCE IDl� <br /> -- — _ _ ._ _ __ _ __ _ (OBTAINED FROM PROPERTY TAX NOTICE) <br /> MlORK PROPOSED NEW CONSTR ADD/AL 0 SIGN Q � Q DEMOLISH <br /> B INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE O�LONSTRUCTIOM Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK � � !�. ✓�%�°'� ��G �S � �7 � <br /> BUILDIMG SIZE SQ FOOTAGE 11EIGHT <br /> OBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVI E Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> ECHANICAL $ pa' VALUATION OF MECHANICAL INSTALLATION `� �� <br /> � � Sgs �S <br /> � <br /> QGAS Q ROOFING Q SPECI TY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD OIVE AREA QYES NO <br /> BUILDER CO PANY <br /> SIGIdATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> EL.ECTRICIAN CO PANY <br /> SIGfdATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER CO PAMY <br /> SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL � �� C PANY ��VHd�S 2d �v �iP.S � � �' <br /> SIGfdATURE � RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �Q G D y.�9�/� <br /> OTHER C MPANY <br /> SIGMATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2).Plot Plans;(2)sets of Building Plans;(1)set f Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days aRer submittal date. R quired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities&1 dumpster;Site Work Permit for bdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Pians plus a Life S fety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. R qulred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster._Site Work Permit for II new projects.AII commercial requirements must meet compliance <br /> SIGId PERMIT Attach(2)sets.of Engineered Plans. ` <br /> """PROPERTY SURVEY required for all NEW constru tion. <br /> Direc4lons: <br /> Fill out applicaUon completely. r <br /> Ovmer&Contractor sign back of application,notarized �` <br /> If over 52500,a Notice of Commencemerit isrre,qr�ired. (AIC upg ades over 57500) <br /> •• Agent(for the contrac4or)or Power of Attomey,�'(for the tiwner)would e someone wlth notaNzed letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING,.�",` ' (Fronf�of,A`pplic�tion Only) <br /> Reroofs if shingles `� -Sewers �•�•��Serv1a�,Upa.rades'A!C Fence (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on publfc roadways..needs ROW <br />