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813-780-0020 City of Zephyrhi Is Permit Application Fax-813-760-0021 <br /> s <br /> • Buildi g Department <br /> Date Fteceieed Phone Contact f r Permitting __ <br /> O�nrner's Mame W%��� � �V I J�/�F��C� Owner Phone fdumber <br /> Obrner's Address � G� Cr Uv/Z% ,�� �rvn�r F'hone Rlumber <br /> i �ce Sienple Titleholder R1ame Owner Phone idumber <br /> Fee Simple Titleholder Address <br /> .dOB 81DDRESS ��U� L`C�U�% r i"^ � LOY# �� <br /> sua�idisiob Wr�LN�/7' (',Qav� �s►RC� i�# - <br /> ` (OBTAINED FROM pROPERTY TAX NOTICE) <br /> lfNOEtE(�ROPOSED NEW CoNSTR ADD/AL 0 SIGIJ Q Q DEMOLISH <br /> INSTALL B REPAI <br /> ��tOPOSE�USE Q SFR Q COfV1M � OTHER <br /> �PIE OF COMSTRUCTIOfd Q BLOCK Q FRAME � STEEL Q <br /> A�SCRIPTIOfd OF lMORK � r G�/J�/'� U G ��/�'G� <br /> �UILD9�IG SIZE SQ FOOT�IGE HEIGHT <br /> �BUILDING $ �, v VALUATIOM OF TOTAL COfVSTRUCTION <br /> lo �oo. <br /> QELECTRICAL $ AMP SERVI E � PROGRESS ENERGY 0 W.R.E.C. <br /> �PLUMBING $ <br /> QMECHAfVICAL $ VALUATION OF MECHANICAL INSTALLATIOfV <br /> �GAS Q ROOFIMG [� SPECI LTY � OTHER G��C� �j� <br /> FIfVISHED FLOOR ELEVATIOMS FLOOD ZONE AREA DYES NO <br /> BUILDER /^ J� C RAPAMY / !I - U F�i�'�-Lr C o C <br /> �BGfdA�URE L' ` � RE ISTERED M FEE CURRE� �/fV <br /> Address License# <br /> IELEC7'RICIAM C IIflPA�Y <br /> SIGfd�1TURE RE ISTERED Y/ PV FEE CURRE� Y/N <br /> Address License# <br /> PLUhflBER G IlflPA1dV <br /> SIGMAITURE RE ISTERED Y/ N FEE CURRE� Y/I�I <br /> dlddress License# <br /> Mi�CHAfdIC.4L C AHPAMY <br /> SOG�ATUEZE RE ISTERED Y/ N FEE CURRE� Y/IV <br /> Address License# <br /> OTHER C iNiPAPlY <br /> SIGfdATURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDEMTIAL Attach(2)Piot Plans;(2)sets of Building Plans;(1)se of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10}working days after submittal date. equired onsite, Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for ubdivisions/large projects <br /> COi1�RAERCIAL Attach(3)complete sets of Building Plans plus a Life afety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. equired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGkI PERflAIT Attach(2)sets of Engineered Plans. <br /> °'""PROPERTY SURVEY required for all fVEW constr ction. <br /> Directions: <br /> Fill out application compietely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Idotice of Commencement(s required. (A/C up rades over 57500) <br /> �� Agent(for the contractor)or Power of Attomey(for 4he owner)woul be someone with notarized letter from owner authorizing same <br /> ONER THE COUNTER PERMITTIfdG (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fenc s(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />