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813-780-0020 City of Zephyr ills Permit Application Fax-813-780-0021 <br /> Build ng Department <br /> � <br /> �ate Receieed� Phone Contact oP Permitting � __ c3��j`� <br /> O�rner's Idame ��� � �� Oarner�'hone Rluenber <br /> Owner's Address �ner 6'hone Mumber <br /> Fee Simple Titleholder tdarne Ovvner Phone idumber <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS s LO'T# �� <br /> SUBDIbISIOM PARC L ID� <br /> (OBTAIPIED FROhA PROPERTY TAX tdOTICE) <br /> WORE(P6tOPO�ED � nIEW CoNSTR e ADD/A T � SIGN Q � DEMOLISH <br /> INSTALL REPAI <br /> �ROP05EI�USE Q SFR Q COMM 0 OTHER <br /> F1fPE OF COfdSTitUCTlOfd Q BLOCK Q FRAM 0 STEEL Q <br /> D�SCEtI�TIOfd OF HNORK � S D <br /> 19l➢ILDI(dG SIZE � SQ FOOT4IGE HEIGHT <br /> �BUILDING $ :�� o VALUATIO OF TOTAL COPVSTRUCTION <br /> QELECTRICAL $ AMP SERVI E � PROGRESS EPIERGY � W.R.E.0 <br /> OPLUMBING $ � ` ,/l� <br /> N�� <br /> OMECHANICAL $ VALUATIO OF MECHAIJICAL INSTALLATION �.S-� / �"'�"� <br /> . a �.��o <br /> �GAS Q ROOFING Q SPECI LTY 0 OTHER �� <br /> FINISHED FLOOR ELEVATIONS FLOO ZONE AREA QYES NO <br /> (�l <br /> BUILD�R i / ��C P/oMY � �v� ,9�/�J��' <br /> SIGfd?\TURE � RE ISTERED Y/ N FEE CURRE� Y/f�l <br /> e4ddress License# <br /> �� <br /> IELECTI�ICIAfd � �� C IlAPARlY �%/. � d ����\ <br /> SIGidA7'URE RE ISTERED Y/ IV FEE CURRE� Y/N <br /> �.ddress License# <br /> ��u�e�R ��c nnPA�v �-�_ ��,t/��"-' <br /> SIGidATURE - Re ISTERED Y/ N FEE CURRE� Y/(V <br /> �lddress � License# <br /> RAECHANICAL / ' -- � C MPAIdY (�`o� � ��f�� d� <br /> SIGfdA�'URE RE ISTERED Y/ N FEE CURRE� Y/N <br /> �►ddress License# <br /> OTHER C MPAtdY <br /> SIGMATI.ORE -R_GISTERED Y/ N FEE CURRE� Y I N <br /> ,Address License# <br /> RESIDERITIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)se of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)worfcing days after submittal date. equired onsite, Construction Plans,Stormwater Plans w/Silt Fence instailed, <br /> I Sanitary Facllities 8 1 dumpster;Site Work Permit for ubdivisions/large projects <br /> COAARAERCIAL 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/Siit Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permft for II new projects.All commercial requirements must meet compliance <br /> SIGR1 PERMIT Attach(2)sets of Engineered Plans. <br /> '°'•PROPERTY SURVEY required for all NEW constr c8on. <br /> Direc4tons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a(dotice of Commencement(s required. (AIC up rades over�7500) <br /> •' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> ONER THE COUNTEEt PERMITYING-.- - (Front of Application"Only) , , . ' � � . ', <br /> Reroofs if shingles Sewers �� Service Opgrades NC- Fence (PIot/Survey/Footage) �� ; <br /> DPiveways-Not over Countec if on putilic roadways..needs ROW -- _• -- . , �_ _ � <br />