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813-780-0020 City of Zephyrhi Is Permit Application Fax-813-780-0021 <br /> � <br /> Buildin Departrnent <br /> Date Received 1� �G�'9 -- G/'JC`� <br /> Phone Contact i r Permittin <br /> Oe++ner's fVame e /� ���� Owner Phone Mumber <br /> Oumer's a4ddress 0"0 !i d 3! �i(0 ��� p� �J. � D Owner Phone Number <br /> Fee Simple Titleholder Name Gt/ Ow►ner Phone Numbea <br /> Fee Simpie Titleholder Address �? <br /> JOB ADDR�SS S .r—� S� P N � �3�� LOT# � <br /> SUBDINISION PARCE ID# �/Of b"���o%`�3�DO"��'� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CoNSTR ADD/AL 0 SIGM Q ' Q DEMOLISH <br /> e INSTALL B REPAIR <br /> PROPOSED U�E Q SFR Q COMM 0 OTHER <br /> IYPE OF CONSTRUCTIOM Q BLOCK Q FRAME 0 STEEL � <br /> DESCRIPTIOM OF lNORK � O /1'e / �' S/�c �� �I O��J�� � h(�Li/ S/� � <br /> BUILDIMG SIZE SQ FOOTAGE n�0 O S HEIGHT <br /> QBUILDING $� /�� S� �� <br /> .� VALUATION F TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVI E � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �f_ <br /> � f_ {U <br /> t Ip <br /> QMECHANICAL $ VALUATION F MECHANICAL INSTALLATIOfV .�f,r � <br /> QGAS Q ROOFING Q SPECI TY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ONE AREA QYES NO <br /> BUILDER CO PANY <br /> SIGM�ITURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> EL.ECTRICIAN CO PANY <br /> SIG(dATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER CO PAMY <br /> SIGfVATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL CO PAWY <br /> SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER C MPANY ��`�` � �O t P l <br /> SIGMATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address pQ� D �/G ' f S C `��+N �°� �1� �^•3 y�� License# <br />� RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> M(nimum ten(10)warking days after submittal date. R quired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster;Site Work Permit for ubdivisions/large projects - <br /> COMMERCIAL Attach(3)complete sets of Building 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 quired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for II 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 /> Directlons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over y2500,a Notice of Com[nencementJs.�equired.....(AI,C_�P9 ades over�7500) <br /> •' Agent(for the contractor)o�Power of At#omey_(for the owiner)'woul'd e someone with notarized letter from owner_authorizing same_. _ <br /> l, `: � . ,- _ . -. -� ..., . . . <br /> OVER THE COUNTER PERMITTING ; .,;(Front of;Application Only)� �-� . � <br /> Reroofs if shingles Sewers, °= 'Service Upgrades A/C �..,, ��=Fence (Plot/Survey/Footage) � - _ ° � . ; <br /> ....-< ... . ............... . .,_ _...,.;�. .:. , . . . . ,. ._ : <br /> Driveways-Not over Counter if on public roadways..needs ROW __,-„ . ;;,_,� ... .-:_, _ .� ,,:. _. �-. . .. <br />