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�-- i . <br /> i s�3aso-oozo City of Zephyrhi Is Permit Application Fax-813-780-0021 <br /> Buildin Department <br /> Date Received Phone Contact fqr Permlttin � �O� __ � l} c <br /> Ourner's►dame /1�/ �a- L,�� L/�� Oeener Phone Idumber �lJ� ��✓' ���� <br /> Owmer's e4ddress �g9/ � L� ��j � S ,�/� Owner Phon�Number <br /> ��.'�Z�,,�5/ <br /> Fee Simple Titleholder IVame O�nrner Phone Fdumber <br /> Eee Simple Titleholder Address <br /> JOB ADDRESS �!S/ L, QC-GG�2L` I�i4`�G 1 � QS �� G S LOT# � <br /> SUBDIbISION ✓Q'/ �' '�/(� /g PARCE !D# °1� o�lp o�� DD��/ D�CO� vd�� <br /> (OBTAINED FROM pROPERTY TAX NOTICE) <br /> HNORK PROPOSED NEW CONSTR v ADD/AL � SIGN Q Q DEMOLISH <br /> B INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTIOR9 Q BLOCK Q FRAME 0 STEEL 0 <br /> DESCRIPTIOM OF MIORK � � —('j� <br /> BUILDIRIG 51ZE SW FOOTAGE HEIGHT <br /> QBUILDING $ VALUATION F TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVI E 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ^ <br /> � i <br /> QMECHANICAL $ ���r b� VALUATION F MECHANICAL INSTALLATION �l�� <br /> J � <br /> QGAS Q ROOFING Q SPECI TY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ONE AREA DYES fV0 <br /> BUILDER CO PANY <br /> SIGRIATURE RE ISTERED Y/ fV FEE CURRE� Y/N <br /> 6�ddress License# <br /> ELECTRICIAM CO PAfdY <br /> SIGfdAtURE RE ISTERED Y/ N FEE CURRE� Y/fV <br /> Address Llcense# <br /> PLUMBER CO PAMY <br /> SIGMATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL �' �] ,���,,,, a � C (�IPAPIY �i�f/�S j��Ne-�5�r"G'- �� <br /> SIGfdATURE //���-�/Jw�— RE ISTERED Y I N FEE CURRE� Y/N <br /> Address ��T� �l�/C.� Q� �/`?�l License# ����3�'Z�c� <br /> OTHEFt C MPANY <br /> SlGIdATOJRE � � � � tiE ISTERED Y/ N FEE CURRE� Y/N <br /> Alddress License# <br />� <br /> RESID�(dTIAL 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 Faclllties 8 1 dumpster;Site Work Permit for ubdivlsions/large projects <br /> COMAAEEiC1AL 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 subm(ttal date. equired onsfte,Construction Plans,Stormwater Plans w/Silt Fence instal!ed, , - <br /> Sanitary Facillties&1 dumpster.Site Work Permlt for II new projects.AII commercial requirements must meet compliance <br /> SIGM PERMIT Attach(2)sets of Engineered Plans. <br /> "'"PROPERTY SURVEY required for all NEW constnjctlon. <br /> Directlons: <br /> Fill out application completely. <br /> Ovmer 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (�,/C upg ades over�7500) <br /> `• Agent(for the contractor)or Power of Attomey(for the owner)would e someone with notarized lette��f�om owner authoriiing same � ; <br /> t - . . t <br /> OVER THE COUNTER PERMITTING (Front of Application Only) ,•�, • ' ' ' ; <br /> Reroofs if shingles Sewers Servlce Upgrades A/C Fence (PIoUSurvey/Footage) . •� � � . ; � <br /> <. ., ,.. ,.,. _.. ....... ... .... ..,.-„._�, <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />