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� a�3�so-oozo City of Zephyrhilis P rmit Appiication Fax-813-780-0021 <br /> „- - <br /> i Buiiding Oe artment <br /> Date Received <br /> Phone Contact for Pe ittin <br /> i � � 0 A 1 1 � 6 . H 1 � 6 , <br /> Owner's Matne ��l�G�("�-� �O f�5 (�,,�ECl Owner Phone Tdumber �� 3 �1-��— ��o b O <br /> Owner's Address ���3 a�'!O �(�_ Owner Phone Number �—_-- � <br /> Fee Simpie Titleholder Naene Owner Phone Number �-'� � <br /> Fee Simple Titleholder Ac6dress <br /> � Jd8,ADDRESS (,SJ�� C:,,�t 1 O V�- LOT# �V� <br /> � � <br /> SUBDtVlSION �T�� � � PARCE�ld <br /> {pBTAINED FROM PROPERTY TAX NOTICE) <br /> WCfRK PRQp05ED e NEW CONSTR 8 ADDlALT � SIGN � � � DEMOC.ISH <br /> iNSTALL REPAiR <br /> PROPOSED USE � SFR � COMIVi � OTHEF2 <br /> TYPE OF COi�STRUCTiON � BLOCK � FRAME u STEEL 0 <br /> DESCRlPTION OF WORK � � , ��'tGt Q ��-� � ''�p(1 ��' �j�✓v� <br /> BU4LDING SIZE �— � SQ FO(7TAGE HEIGMT ��� <br /> �BU�LDiNC" � VALUATION O TOTAL CONSTRUCTION <br /> �—� <br /> ` �ELECTRICAL ��� RMP SERVIC 0 PROGRESS ENERGY � W R.E.G. <br /> i <br /> �PLUMBlNG $ � � <br /> ��� <br /> �MEC1iAN1GAL $ �q,o� ,pp VAL.UATION F MEGHANIGAL INSTALLAT4C7N ;} `� <br /> t 3rt <br /> OGAS � ROflFlNG � SPECIA TY � OTHER <br /> F1N�SHED FLOOR ELEVATiC7NS � � FLO(JD C7NE AREA DYES NO <br /> pe���p ■ e n > > . n n � .��ti.x.i.— m t e a . . e <br /> BUIL�ER G PANY <br /> S1GI3ATURE RE ISTERED Y/ N FEE CURREM1 Y J N <br /> Address License# �---�—_ ---� <br /> � <br /> ELECTRICIAT� G MPANY <br /> SIGNATURE R GiSTERE4 Y i N FEE CURREt� Y!N <br /> Address L{cense�P ^� <br /> PLUMBER � OIVIPANY <br /> SIG(�ATURE Gi5TERED Y! N FEE CURREq Y I N <br /> Address License# �^y—,—��—� � <br /> MEGHANICAL � �� �� QIViPANY �1�� 1-�'C !'`1' r �f"`{ �fCt1(iD(l� '��'� <br /> SIG4VATt1RE �_��J��J�-`-""���f G� � EGIS7ERED N FEE CUftRE� Y!N <br /> Address 3S lp � �~—( License# ��3�—i���� GCo I <br /> OTNEft �� � COMPANY <br /> StGMATURE Re��sTERCO Y/ N FEC cuaREn Y!�� <br /> Address License# � � <br /> fle6nin1 : 4 : 8l1 ° � � lSlB ➢ II6A � � i � EtB CA � i116i � ➢ @E81E � 1lB41 ! lllflll � IAHU86t <br /> RESIDENTIAL Atfach(2}Piot Pians;(2)sets af Building Plans;{1 set oF Energy Forms;R-O-W Permit far new cor,sfructio�, <br /> Minimum ten(10)worlcing days affer submiital dat . Required anslte,GonsUuctioc�Plans,Stormwater Plans w/Silt Fence installed, <br /> M Sanitary Faci4iUes&1 dumpster;Site Work Permi for subdivisionsliarge projects <br /> COMMERCIAL Atlach(3}complete sets oi Buifding P{ans p4us a ife Safety Page;{1)s�t af Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten{1 Q}worici�g days affer submittai da e. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence insialied, <br /> - Sanitary Facilities&1 dumpster.Site Worlc Permi for aII new projecfs.AI(commercia{requirements must mset comp4iance <br /> SlGN PERMIT Attach{2)sets of Enginaered Pians. <br /> '""`"PRQPEF2TY SURVEY required for atl NEW c nstruction. <br /> �n n n ■ r,�m � e�s�a+v ��T"w—&e-or..°�'�.°ce•i�•w"a^,�a"��:rs <br /> Directions: <br /> Fiii out app4ication completely <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement ts required. (A! upgr�des aver$T500a <br /> *" Agent(for the contracYor)or Power of Atlorney{for the owner) ould be someone wiih noiarized}etter from owner authorizing same <br /> OVER THE COUNTER PERtUifTTIt3G {Ftont of Application O ly) <br /> Reroofs if shingles Sewers Service Upgrades A/C ences(PIoUSurveylFoatage) <br />; Driveways-Not over Counter if on public roadways..needs RO <br />