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a1�3-aso-oozo City of Zephyrhiils Permit Application Fax-813-780-0021 <br /> ` l Buiiding epartment <br /> Date Received � <br /> Phone Gontacf for ermitfing - <br /> eouee � aa ee � ea <br /> Owner's Mame �e1��!'�/�e. -�" �,c�("�Q t'1 J�'t��-� �i"c,t S� Owner Phone hlumber O i� 7���" ��JC�C� <br /> Owner's Address �If.� �• �f'�1 t7�WG�$$-e'C- �'� ��t`'`ntt � � <br /> 8J2-7 Owner Phone Numbor <br /> Fee-Simple Tifiehoirier Navne � Owner Phone Number � � <br /> Fee Simpie Titiehoider Address <br /> JOB A,DDRESS �(,7�� J Cf+'� �i� '� ��'. LOT# � <br /> SUBD{V4SION �� � PARCE41 # <br /> (4BTAlNED FROM PRpPERTY TAX NOTICE) <br /> ,' WQi2K PROPOSED NEW CONSTR AC7DlALT � SlGN Q � DEMOL(SH <br /> � 1NSTALL 8 REPAIR <br /> PROPOSED USE � SFR � COMM t� (7TNER <br /> TYPE OF COMSTRUCTION Q BLOCK Q FRRME U STEEI. � <br /> DESCRIPTION pF Vi/ORK �I� �nci�i ��� � c� S�Yl 1 1�Gti Pi�t�vt S h c� *��/S�M <br /> BUtLD1htG S1ZE �T- � SQ FOt}TAGE HElGHT �_�� <br /> �s~ <br /> �BUILDING � � VALUATION F TOTAL CONSTRUCT(ON <br /> DE�ECTRtCAL �� RMP SEftVI E O PROGREBS ENERGY Q W.R.E.0 <br /> �PLUMBING ��� ���� <br /> �MECHANICAL $ ��� /Qp VALUA710 OF MECiiRNiCAt INSTA�LR7tON � 1 <br /> �GAS � RdOFiNG � SPECI LlY � C7TNEft <br /> FlNISHED F�OOR ELEVA7IONS C�� FLOO Z(7NE AREA �YES NO <br /> ■ � v a • i � <br /> BU4LDEl3 � � G iNIPAT3Y <br /> SIGNATURE R GISTERED Y I N FEE CURRE� Y/N <br /> Address License# [----_- � <br /> IE4ECTRICIAM � T pNiPANY <br /> � <br /> SlGMATURE EGiSTERED Y I N FEE CURREA Y!IV <br /> Address license# �-_- � <br /> PIUMBER OMPANY <br /> SIGNATURE EGISTERED Y! I�l FEE CURRE� Y/N <br /> Address License# �-,--- �� <br /> NIECHAI�{CAL ` ..--� COIitiPANY �� !�-'-C�'� / �t� T( �dl7 L.L.-� <br /> SIGNATUR,E REGISTERED (V FEE GURRET Y i N <br /> � <br /> Address ��"'Y,�O � � l'�JR Q �� License# ���-� �,�� C � � <br /> OTHER COMPANY <br /> SIGNATURE REGiSTERED Y/ N FEE CURRE� Y 1 N <br /> Address License� � � <br /> - - � n s 8@ �-P-9 !_!_0 1-p_8 B 9 ! ! 1@ S 9 ! 9 ➢. 0 � A � 6 If il � 6 B E 1 1 1 6 1 I i@ S 9 1 i 1 { ! � 0 ! 1 1 ! i ! II 8 & 1 8 p 9 ! I <br /> RESlDENTIA� Aitach(2j Plot P(ans,(2)sets of Buiiding Pians;O set of Energy Forms;R-O-V`J Permit for new construction, __ <br /> � Minfmum ten{10)war{cing deys after submiftai da e. Reqvired onsite,Constcuction P4ans,Stormwater Plans w!Silt Fence instafled, <br /> Sanitary Facilities&1 dumpster;Site 1Nork Perm' for subdivisionsliarge projects <br /> COMMERCIAL Attach(3)compiete sets of Building Pians pius a iFe Safety Page;(1)set of Energy Forms.R-O-W Permii for new consttuction. <br /> Minimum ten(14)worlcing days after submitta�d te. Required onsite,Consfruction Pfans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpstec Site Wark Per t for af!new projecfs.Aii cammercial requiremenfs must meet comp4iance <br /> SfGN 4'ERMIT Attach(2)sets of Engineered Pians. <br /> '"""PROPERTY SURVEY required for all NEW nsiruction. <br /> e e . n � _ <br /> Directions: <br /> Fiii aUt appiicatiort campletely. <br /> , Owner&Contractor sign back of appiication,notarized <br /> !f over$2500;a iVotice of Commencement is required. (A!_ upgr�des over$7500) <br /> ** Agent{for ihe contractor}or Power of Attorney{for the ownec) ouid be someone with notarized tetter frvm owner authorizing same <br /> OVER"i'HE COUNTER P�RMITTING (Front of Applicatian O ly) <br /> Reroofs if shingles Sewers Service Upgrades A1C Fences(PfoVSunreylFootage) <br /> Driveways-Not aver Counter if on publlc roadways..needs R W <br />