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613-780-0020 City of Zephyr ilis Permit Application Fax-813-780-0021 �, <br /> Build ng Department <br /> Date Received R—�b...! Phone Contact or Permitting ��� �?7 --78�� <br /> Owner's R1ame �' � W r5Z J✓��, � Owrner Phone Rlumber I � • <br /> Owner's�4ddress s��Sw �Gi e, eg�'. O�nmer Phone Mumber <br /> Eee Sienple Titlehalder R9ame Owner Phone Idumber <br /> I Fee Simple Titleholder Address � ° �: <br /> JOB d1DDRESS J?•1 S IZ�� G �S'F. Z t Q�y /�i( ��• .��6�2. LOT� � <br /> suaDidisiora PARC LID# In���"Z �" 00'f0-op3oo -OC6(.__ __ __ ___ <br /> _ - , - -- -— - - ^ ` (OBTAIkED FROM pROPERTY TAX NOTICE) <br /> MlORK PROPOSED NEW CoNSTR ADD/A T 0 SIGN Q Q DEMOLISH <br /> B INSTALL B REPAI <br /> PROPOSED U�E Q SFR Q COM 0 OTHER <br /> TVPE OF COfdSTRUCTlO(d Q BLOCK Q FRAiVi � STEEL Q � <br /> DESCRIPTIOM OF HHORK 3 t�+.r a r eN-4�' �oc�� ��,o��s! ,�',�,s�4//e i.ueof e�f <br /> ISUI�DIfdG SIZE 1 Z�V � . SQ FOOT�4GE 1 z1 EiEIGH� <br /> . BUILDING $ ( r ��. o� ,VALUATIO OF TOTAL CONSTRUCTION <br /> �Q <br /> QELECTRICAL $ AMP SER ICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> QMECHANICAL $ VALUATIO OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPEC ALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOO ZONE AREA �YES fV0 <br /> BUILDER pwr �,o��/ � C IVIPARIY ��1 LI <br /> SIGMATURE " ° �-�_=e:--�:=- :� R GISTERED Y/ N FEE CURRE� Y/N <br /> 4►ddress �+0'f' �}+G�l al✓C� Z �l /'lLi�� /• s3`'S�L- License# �-'�- � Z S!o 1 g� <br /> �LEC'TRICIAfd C MPAIdY <br /> SIGtdATURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUIMBER C IlAPAidY <br /> SIGMATURE " R GISTERED Y/ N FEE CURRE� Y/I�I <br /> s4ddress License# <br /> MECHANICAL OMPAMY <br /> SIGk1ATURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER OMPANY <br /> SIGMATURE GISTERED Y/ N FEE CURRE� Y/N <br /> dlddress License# <br /> RESIDEMTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)s t of Energy Forms;R-O-W Permit for new construction, <br /> Minlmum ten(10)working days aRer submittal date. equired onsite,Construction Plans,Stormwater Pians w/Siit Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site 1Nork Permit fo subdivfsions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Pians plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)workfng days after submittal date. Requfred onsite,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.S,ite Work Permit fo 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 /> Dlrections: <br /> Fill out applicatfon completely. <br /> Owner 8 Contractor sign back of application,nota�(zed <br /> If over 52500,a tdotice of Commencement ts required. (A/C u grades over�7500) <br /> •" Agent(for the contractor)or Power of Attomey(for the owner)woul be someone with notarized letter from owner authorizing same <br /> ONER TNE COUNTER PERMITTING (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 />