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813-780-0020 City of Zephyrh Ils Permit Application Fax-813-780-0021
<br /> Buildi g Department
<br /> Date Received �C �I� �C c� __ (���
<br /> o�-� � Phone Contact r Permittin -L V —101
<br /> Obrner's(Name W�111 �W �E3�-�' Obrner Phone Mumber
<br /> Owmer's dlddress ��s �►J1����{x�6� �`� Owmer Phone Number
<br /> Fee Simple Titleholder Name Ov�mer Phone Number
<br />' Fee Simple Titleholder Address
<br /> JOB AD�RLSe• , � a� CSQL�, �� Z�.Q��\��i\� LOT#
<br />� SUBDINISION PARCE ID# � c�s oZ� � I� C�j�'QO� Q O(��
<br />,_-- - __ __ ___ _� , _ __ _ __ _- __ (OBTAINED FROM PROPERTY TAX NOTICE) i _
<br /> WORK PROPOSED B NEW CONSTR e ADD/AL � SIGM � ' Q DEMOLISH
<br /> INSTALL REPAI
<br /> �ROPOSED USE , Q SFR Q COMM � OTHER
<br /> 71fPE'OF�ONSTRUCTIOM Q BLOCK Q FRAME 0 STEEL Q
<br /> DE�CRIPTIOM OF 1NORI( ��1� 1�� CUOa� '6 �,`Q`S
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br /> QBUILDING $ G� �� VALUATION OF TOTAL CONSTRUCTION
<br /> -� �
<br /> QELECTRICAL $ AMP SERVI E Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �S�p V�
<br /> QGAS Q ROOFING Q SPECI LTY [� OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ONE AREA �YES NO
<br /> .•__�
<br /> _ �
<br /> BUILDER CO PAMY 5u� S�'� C�—U'�
<br /> SfGTdATOR RE ISTERED Y/ N FEE CURRE� Y/N
<br /> Address ��54- '� ,G�' � � License# `�
<br /> ELECTRICIAN CO PANY
<br /> SIGIdA'TURE RE ISTERED Y/ N FEE CURRE� Y/M
<br /> l�ddress License# —�
<br /> PLUMBER CO PARIY
<br /> SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> MECHANICAL CO PAfVY
<br /> SIG(dATURE RE ISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> OTHER C PANY
<br /> SIGtdATURE RE ISTERED Y/ N FEE CURREA Y/N
<br /> Address License#
<br /> RESIDEMTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set f Energy Forms;R-O-W Permit for new construction,
<br /> Minimum ten(1Q)working days after submittal date. R quired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facllities 8 1 dumpster;Site Work Permit for s bdivisions/large projects
<br /> COMAAERCIAL Attach(3)complete sets of Buildfng Plans 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 qu(red onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitfes&1 dumpster.Site Work Perm(t for I new projects.All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans.
<br /> •'••PROPERTY SURVEY required for all NEW constru tion. �
<br /> Directions:
<br /> Fiil aut application completely. , '
<br /> Ovmer 8 Contractor sign back of application,notarized
<br /> If over E2500,a NoNce of-Commencement-is required.•.,(AI,C upg des over 57500) ' ' � _.�--
<br /> j� � 1- 'h, - 1 � .���•�. i .i i . ., ..:a...�.a.�.^=".......�... -.;m'„•.;;;��•_� �ry�
<br /> •" Agent(for the contractor)or Power of,Attomey`(for_the.�o`wner).vyould e someone with notarized fet�er'frorii�owner,authorizing sa�ne ,;•�,,, �: -
<br /> Ol/ER THE COUNTER PERMITTING'-_ ,.' (Front of;Application;Only) �� � - _ ` , ; �, ' � �
<br /> Reraofs if shingles Sewers` � Service Upgrades AlC; Fences(Pfot/Survey/Footage) '; � � ;
<br /> ,,. ,
<br /> �.,....,. ....,.:,..>,:.,r.::,-,-. .-.�,-.. { , ,, , � ...,
<br /> Driveways-Not over Counter if on public roadways..needs ROW '`_°`-.�.•�'-��� �Y�••_;"' - ''"
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