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e�saeaoozo� City of Zephyr ills Permit Application Fax-813-780-0021 <br /> ' Buildi g Department <br /> Date Received .� ��- Phone Contact r Permitting __ <br /> Ouvn�r's Name Owner Phone Number °- � °s � � <br /> Owner's Address J�� p� � �. Obmer Phone Number <br /> Fee Simple Titleholder Mame Owner Phone Mumber <br /> Fee Simple Titleholder Address <br /> - <br /> JO�ADDRESS � 6•' /���v L.OT# <br /> SUBDIVISIOM PARCE ID# ---- - - -- -- - `�----_ -_— <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORa(PROPOSED e NEW CONSTR e ADD/A �.� SIGN Q Q DEMOUSH <br /> INSTALL REPAI <br /> � PROPOSED USE � SFR Q COMM [� OTHER <br /> TYPE OF CONSTRUCTIOM BLOCK Q FRAME '0 STEEL Q <br /> DESCRIPTION OF UbORlC � . `C� I\ C( ��Yi-� /�CY/Wt.O , � �'� � <br /> / �r <br /> BUELDIMG SIZE � � S(d FOOTAGE HEIGHT <br /> OBUILDING $ d VALUATION OF TOTAL CONSTRUCTION <br /> �- <br /> QELECTRICAL $ ,��� � AMP SERVI E � PROGRESS ENERGY Q W.R.E.0 <br /> QPLUMBING $ <br /> OMECHANICAL $ VALUATION OF MECHAIVICAL INSTALLATION �5 � �/ <br /> � � <br /> QGAS Q ROOFING Q SPECI LTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES NO <br /> � <br /> � <br /> BUILDIER C MPANY � ,� � <br /> SIGId91TURE RE ISTERED Y/ E C RRE� Y/N <br /> alddress License# <br /> i � <br /> ELECTRICIAN MPAMY <br /> SIGMATURE � RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMIBER C MPAMY <br /> SIGIdATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL C MPANY <br /> SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER C MPANY <br /> SIGIdATURE RE ISTERED Y/ IV FEE CURRE� Y/N <br /> I►ddress � License# <br /> RESIDENTIAL 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)working days after submittal date. quired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities 81 dumpster;Site Work Permit for ubdivisions/large projects <br /> COAAMIERCIAL 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. equfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Perm(t for II 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 ctlon. <br /> Directions: <br /> Fill aut application completely. - <br /> Owner&Contractor sign back of application,notarized <br /> If over S2500,a Notice of Commencement Is required. (A/C upg ades over�7500) <br /> •" Agent(for the contractor)or Power of Attomey(for the ov+mer)would e someone wlth notarized letter from owner authorizing same <br /> ONER THE COUNTER PERAlIITTING (Front of Application Only) � • __. ' <br /> Reroofs if shingles Sewers Servlce Upgrades A/C Fence (Plot/Survey/Footage) • � � <br /> Driveways-Not over Counter.if on public roadways::needs ROW ' <br />