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� a�3aeo-oozo City of Zephyrhil s Permit Application Fax-813-780-0021 <br /> Buildin Department <br /> Date Received <br /> Phone Contact fo Permitting ��� �� -- �j d <br /> Owner's Plame ��- ��1� Owner Phone Rlumber �6�3-- ��a-�s18 <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �p( ���\�G ��r LOT# � <br /> SUBDI!lISION PARCEL ID# <br /> _ __ _ ____ _ _ � _ _ (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR e ADD/AL � SIGN Q Q DEMOLISH ^ <br /> INSTALL REPAIR <br /> PROPOSED USE . Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �Kl �LL N�l,v .I� �} CO+�• <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING � VALUATION F TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVI Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �,/ <br /> �(i � <br /> �ECHANICAL $ VALUATION F MECHANICAL INSTALLATION :1��� <br /> (� Q�• <br /> QGAS Q ROOFING Q SPECIA TY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ONE AREA QYES NO <br /> BUILDER CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N . <br /> Address License# <br /> ELECTRICIAN CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUIMBER CO PANY <br /> SIGNATURE REG TERED Y/ N FEE CURRE� Y/N <br /> �4ddress License# <br /> MECHANICAL _ CO PANY /-�� ��V��,�5 <br /> SIGNATURE REG TERED / N FEE CURRE� Y/N <br /> Address Q�p-�X5 � �O "Z License# ��. {R(S�{G� � <br /> 3 � <br /> OTHER CO PANY <br /> SIGNATURE REG STERED 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 after submittal date. Re uired onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities&1 dumpster;Site Work Permit for s bdivisions/large projects - <br /> COMMERCIAL Attach(3)complete sets of Build(ng Plans plus a Life S ety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permft for al new projects.All commercial requirements must meet compliance <br /> SIGN PERfiAIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW constru ion. <br /> Directions: <br /> Fill out application completely. ' <br /> Owner&Contractor sign back of application,notarized , <br /> If over 52500,a Notice of Commencement is required. (NC upgr des over ET500) ., , , ',. <br /> � ��.. <br /> '" Agent(for the contractor)or Povirer•of•Attomey'(fo��th,e.oV�rtie�)vuo�ild b 'someone with notarized lette��orifi'owner�utho�izirig;sartie;:..� � . <br /> OVER THE COUNTER PERMITTING �: .�(Front of Application Only):- :` s , - , , , � � - 1•'�. K <br /> Reroofs if shingles Sewers Service Upgrades•A/C` Fences PIoUSurvey/Footage) �� . ' . . - � <br /> - , ' • t: . . - - '° <br /> � , , _,.. .,,,:. . . , <br /> Driveways-Not over Counter'ifbn public roadways.:needs ROW���' ` ,`.., `� -, .—. ' , ` ",�� '";""'",� <br />