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�- s�a-�so-oo2o City of Zephy hilis Permit Application Fax-813-780-0021 <br /> Bui ing Department <br /> lDate Eteceieed <br /> Phone Contac for Permitting -- <br /> Owner's Pdame 7 �C Owner Phone Idumber � 7`—./ �V"QSb q <br /> // n � ��_ ✓ <br /> Oxuner's Address ���(f /L � �.i'1�.W� �j 5�/� Ovener Phone I�umber <br /> Eee Simple Titleholder Plame W Ourner Phone Rlumber <br /> Fee�imple Titleholder Address <br /> � ' LOT# �b i� <br /> JO��DDRESS c�� (� � - C <br /> SUBDINISIOfd PAR EL ID# <br /> _ _ - -- - - . -- - --- ' -- -- - (OBTAINED FROM PROPERTY TAX MOtICE)_ - -° --- - <br /> 11HOR6C PROPOSED NEW CONSTR ADD/ LT � SIGfV Q Q DEMOLISH <br /> INSTALL REP R <br /> �FtOPOSED U5E SFR Q ` COM 0 OTHER <br /> TXP�OF COIdSTRUCTIOM BLOCK FRA E S L <br /> _ <br /> DESCRIPTIORI OF HlIORK �I (-� :J. . 3 .� , � , a r , �('6�((� i <br /> . �bhc <br /> BUILDI�dG SIZE � ' � SQ.FOOTAGE HElGHT b o ' <br /> QBUILDING � R'Sr� d VALUATI M OF TOTAL CONSTRUCTION - , <br /> QELECTRICAL $ AMP SER ICE 0 PROGRESS ENERGY Q dV.R.E.C. <br /> QPLUMBIN�- $ �Q <br /> �,� 1 <br /> QMECHANICAL $ VALUATI N OF MECHANICAL INSTALLATION �� � <br /> QGAS Q ROOFING Q SPE tALTY 0 OTHER <br /> FI(VISHED FLOOR ELEVATIONS FLOO ZOfVE AREA YES NO <br /> 0 <br /> �uo�o�a� onn���r =� � i Lc� � <br /> SIGMm.TURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> EILECTRICIAfd URAPAfdY <br /> SIGM14TURE R GISTERED Y/ IV FEE CURRE� Y/N <br /> 64ddress License# <br /> PLUAA�ER INP�►tdV <br /> SlGiddl'TURE R GISTERED Y/ N FEE CURRE� Y/N <br /> Alddress License# <br /> MIECH,41dICAL OMPARlY <br /> SIGMATURE R GISTERED Y/ N FEE CURRE� Y/IV <br /> 6lddress License# <br /> OTHER OAAPANY <br /> SIGfdATIJRE R GISTERED Y/ N FEE CURRE� Y 1 N <br /> Alddress License# ' <br /> RESIDERITIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)s t of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)wbrking days after submittal date. equired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities 8�1 dumpster;Site Work Permit fo subdivisions/large projects <br /> COAAAAERCIAL Attach(3)complete sets of Building Plans plus a Life Safety 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/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit fo all new projects.All commercfal requirements must meet compliance <br /> SIGid PERi@IIT Attach(2)sets of Engineered Plans. <br /> •'""PROPERTY SURVEY�required for all fVEW const uction. <br /> Directtons: <br /> Fill out appiication compieteiy. <br /> Owner&Contractor sign back of application,notarized <br /> Gf over 52500,a Rlotice of Commencement is required. (AIC up rades over$7500) <br /> '• Agent(for the contractor)or Power of Attamey(for the owner)woul be someone with notarized letter from owner authorizing same <br />- ONER THE COUNTER PERMITTIMG (Front of Application Only) ' ; _ � . � ; , � <br /> Reroofs if shingles Sewers Service Upgrades A/C Fenc s(Plot/Survey/Footage) �, _ - �;- �,. ; , -,, . - <br /> ;. . ,. -_ - :� <br /> Driveways-Nof over Counter if on public roadways..needs ROW ,�,, _ _ _ ; a �< -.--• -r `�.;,.;-�``��' �; <br /> . ,.,�,-r.�.,�,.>._: . ,..,..._ ; <br />