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813-780-0020 City of Zephyrhi Is Permit Application Fax-813-7 <br /> Buildin Department � ' <br /> i�S,�L`; <br /> Date Received �Z/'� Phone Contact f r Permittin ��� -- <br /> Ornrner's iName l{�p Obrner Phone Murnber O�^ 7f� e��� <br /> Ouvner's Alddress (:D � ls � Owmer 6'hone Rlumber <br /> �ee Simple Titleholder fdame Ovuner Phone Idumber <br /> Fee Sfmple Titleholder Address <br /> JOB ADpRESS � �� a;� ~ � ' LO'F# � <br /> SUBDI!lISIOM PARCE ID� ��� � -6(SG rpG�o - Oo�`�Q <br /> � (08TAlIdED FROM PROPERTY TAX NOTICE) <br /> HIlOR4i PROPOSED B NEW CoNSTR 8 ADD/AL 0 SIGN Q 0 DEMOLISH <br /> INSTALL REPAIR <br /> �ROPOSED U�E Q SFR . Q � COMM � OTHER <br /> Tl(PE OF COtdSTRUCTIOfd Q BLOCK Q FRAME 0 STEEL Q <br /> DESCREPTIOM OF VNORK �� o--F Lz� ' ,`j s <br /> � <br /> Bl➢ILDIf�G 51ZE �Q FOOYAGE�� 91EIGHT <br /> OBUILDING $ VALUATION OF TOTAL CONSTRUCTIOfV <br /> DELECTRICAL $ AMP SERVI E � PR�G�RF�SS ENERGY 0 W.R.E.C. <br /> S 1��� <br /> PLUMBING $ // ���y � � <br /> 6 � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � �`S�"� � <br /> ��p�l/ <br /> OGAS Q ROOFING Q SPECI LTY 0 OTHER � ���� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO � '�C��� <br /> Q ��� <br /> BUILDEPd CO PAMY <br /> SlGfde4T7JRE RE ISTERED Y/ M FEE CURRE� Y/fV <br /> e�ddress License# <br /> ELECTRICIAN C iNiPA1dY <br /> SIGtdATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMI�ER "/,� >C MIPAMY d-fG�-�'��'ir� �o�lEr �f iG'r <br /> SIG(dATURE r 1 RE ISTERED Y/ N FEE CURRE� Y/ <br /> 4lddress �d� CGUGa LJS ��`� ce! F ,3 �d License# C�yCGs��a 7 <br /> c <br /> AliECHAMICAL C i�IPARlY <br /> SIGIdATU�E RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER C fiAPA1dY <br /> SIGRlATURE RE ISTERED Y/ N FEE CURRE� Y I N <br /> E►ddress License# <br /> RESIDEfdT1AL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. quired onsite, Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for ubdivisionsllarge projects <br /> COMIINIERCIAL 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 Facilit(es&1 dumpster.Site Work Permit for 11 new projects.Ail commercial requirements must meet compliance <br /> SIGtd PERMIT Attach(2)sets of Engineered Pians. <br /> "'"PROPERTY SURVEY required for all NEW cons ction. <br /> Direc4lons: <br /> Fill out applicatlon completely. <br /> Ovmer&Contractor sign back of application,notarized <br /> If over 5a500,a Notice of Commencement is required. (AJC upg ades over;T500) <br /> '" Agent(for the contractor)or Power of Attomey(for the owner)would e someone wlth notarized letter from owner authorizing same <br /> ONER THE COUMTER PERIdI1TTI1dG (Front of Appflcation Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fence (Plot/Survey/Footage) <br /> DriveNrays-Not over Counter if on public roadways..needs ROW ` <br /> � <br />