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s�s-�eo-oozo City of Zephyrl�ills Permit Application Fax-813-780-0021 <br /> , suilaf'ng Department <br /> J <br /> Date Receieed � �� r phone Contact or Permittin f�J� 3�� 7 q� <br /> Ovxner's Mame �( � �r�Ya�i�s Oeuner Phone Mumber (3 ��� �2 <br /> �roner's d�ddress p S Owmer Phone fVumber <br /> Fee Simple Titleholder Mame � 2�� Owner Phone(dumber <br /> Fee S(mpie Titleholder Address �J%�� <br /> .lOB ADDRESS � r D LOT# � <br /> SUBDIMISIOR7 PARC L ID# <br /> , (OBTAINED FROM PROPERTY TAX MOTICE) <br /> WORK PROPOSED � NEW CONSTR e ADD/A T � SIGN Q Q DEMOLISH <br /> INSTALL REPAI <br /> �EtOPOSED USE [� SFR Q COMM [� OTHER <br /> lYPE OF COMSTRUCTIOM Q BLOCK Q FRAM Q STEEL Q <br /> DESCRIP'�IOR1 OF lMOR6f �� � I`L1 <br /> .►-, ' <br /> BUILDIfdG SIZE SQ FOOTAGE HEIGHY ^" <br /> �BUILDING S ���p� VALUATIO OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERV CE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ � e ��� <br /> � � <br /> �MECHANICAL $ VALUATIO OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECI LTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOO ZONE AREA QYES NO <br /> SUIILDER C I�IPANY �L�� "`�'ll�!�UCn [.O <br /> SIGfdATURE R GISTERED Y/ N FEE CURRE� Y/PI <br /> 4lddress � �� �X���ll � ! License# � C � 7 <br /> IELECTIZICIAM C MPANY <br /> �IGfdATURE R GISTERED Y I N FEE CURRE� Y/N <br /> Address � License# <br /> PLUAABER C MPAMX <br /> SIGMATURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL C MPAMY <br /> SIGIdATURE R GISTERED Y/ N FEE CURRE� Y/IV <br /> Address License# , <br /> 04HER C MPANY <br />� SIGR�ATURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESED�fdT1AL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)s 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 Facilities&1 dumpster;Site Work Permit for subdivfsions/large projects <br /> COAAAIIERCIAL Attach(3)complete sets of Building Pians 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 Faciflties d�1 dumpster.Site VVork Permit for all new projects.All commerclal requirements must meet compliance <br /> SIGM PERMIT Attach(2)sets of Engineered Plans: <br /> •'•"PROPERTY SURVEY required for all NEW cons ction. <br /> I Directfons: � � � " <br /> Fill out application completely. <br /> Owmer 8 Contractor sign back of application,nota�ized <br /> If over 52500,a(dotice of Commencement fs required. (IAIC up rades over�7500) <br /> •• Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notaNzed letter from owner authorizing same <br /> 01/ER THE COUNTER PERMITTIMG {Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fenc s(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />