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e�s-�ao-oozo -- City of Zephyrh�lis Permit Application Fax-813-780-0021 <br /> _ Buildi g Department <br /> pate Re��ivE� Phone Contact r Permittin -- <br /> Owner's Mame D bp �- V�tr1t�� ��� Owner Phone Mumber 3• �$0• /��� <br /> Owner's Address �,� � 5� r��i� Owmer Phone IVumber <br /> Fee Simple Titleholder Mame S Ol. � Ovvner Phone Number <br /> Fee Simple Titleholder Address �al�'�.� <br /> JOB ADDRESS �SA�1M P� LO�# � <br /> SUBDINI310N PARC L ID# 0�`��—a�r dbdb —��'y d(���d�D <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> lMORK PROPOSED B NEW CONSTR B ADD/A T � SIGN Q Q DEMOLISH <br /> INSTALL REPAI <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> 7XP�mF CONSTRUCTIOM Q BLOCK Q FRAM 0 STEEL Q <br /> DESCRIPTIOId OF WORK I2� OA.C� �/)')� � �rYj <br /> iBUILDifdG SIZE �Q FOOTAGE H�IGHT <br /> OBUILDING $ VALUATIO OF TOTAL CONSTRUCTI <br /> 0 <br /> QELECTRICAL $ AMP SERV CE PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> OMECHANICAL $ VALUATIO OF MECHANICAL INSTALLATIOfV <br /> QGAS Q ROOFING Q SPECI LTY 0 OTHER <br /> FIfVISHED FLOOR ELEVATIONS FLOO ZONE AREA QYES NO <br /> (�'"� "i <br /> BUI�. C MPANY ,/ \ S � <br /> SI A URE R GISTERED Y/ N FEE CURRE� Y/N <br /> Address �� 7J'� � 0`fj/J` ���ll��/ License# <br /> ELECTRICIAN C MPANY <br /> S�GIdATURE R GISTERED Y/ 111 FEE CURRE� Y/N <br /> Address License# <br /> PLUM�ER OMPANY <br /> SIGIdATURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Address ' License# <br /> AAECHANICAL OMPANY <br /> SIGIdATURE EGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER OiVIPANY <br /> SIGtdATURE EGISTERED Y/ IV FEE CURRE� Y/N <br /> Address License# <br /> RESIDEMTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1) et of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,StoRnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMIIAERCIAL Attach(3)complete sets of Buildfng Plans plus a Lif Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit f r all new projects.All commercial requirements must meet compliance <br /> SIGM PERMIT Attach(2)sets of Engineered Plans. � � • <br /> '•'•PROPERTY SURVEY required for all NEW cons ctlon. <br /> Directions: <br /> Fill out application completely. <br /> Ovmer 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement Is required. (A/C u grades over 57500) <br /> •• Agent(for the contractor)or Power of Attomey(for the owner)wou d be someone wlth notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fen es(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />