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, � <br /> 813-780-0020 City of Zephyrhil s Permit Application <br /> , Buildin Department <br /> Date Received 1 RESTRICT��R <br /> Phone Contact fo Permitting / l restricti�e th� <br /> Oeuner's Name ,�/Q!"'�/�� �0�! Owner Phone PlumbeP N7R�`C'T•vl� <br /> o2q� �! fV s'T 1,L � rtake� <br /> Owrner's Address �L� �A i 15 Ovdner Phone Rfumber <br /> ense <br /> Fee Simple Titleholder Name Ovvner Phone Mumber <br /> f t" <br /> Fee Simple Titleholder Address '' �� <br /> JOB ADDRESS �� � I ��� �!K °C� � /J R �! IS �`�33y� LOT# .� ° 1 <br /> SUBDI!/ISION PARCEL ID# - <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> lMOP26C PROPOSED B NEW CONSTR e ADD/AL � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> 7YPE OF COM�TRUCTIOPf � �BLOCK Q FRAME � STEEL Q <br /> �.I /� I <br /> DESCRIPTIOM OF WORK � ���/-�� /� �R L 2 g� '�— rr/c �j � <br /> euILDING sIZE �� � 1� SQ FOOTAGE .��d� FIEIGHT ��� r�/�,) � <br /> �BUILDING $��r �`�� VALUATION F TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVIC Q PROGRESS ENERGY � W.R.E.C. I <br /> OPLUMBING $ �� <br /> f�5 <br /> OMECHANICAL $ VALUATION F MECHANICAL INSTALLATION <br /> � �' <br /> OGAS � ROOFING Q SPECIA TY 0 OTHER � <br /> FINISHED FLOOR ELEVATIONS FLOOD ONE AREA �YES NO <br /> BIDILDER � ,���, CO PAfdY ��f � .U�''X�JV LCJ�J�T UG'//C?N�� ' <br /> SIGR�ATURE v ��� REGI TERED Y/ N FEE CURRE� Y/N <br /> p � <br /> Address �D � �/� S�e�r Z � '! 5 "' �3S'i�0 License# <br /> ELECTRICIAM CO PANY <br /> SIGtdATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER CO PANY <br /> I SEC�aNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> , Address License# <br /> I MECHANICAL CO PANY <br /> SBGPlATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHE92 CO PAMY <br /> SIGR9d1TURE REG STERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDEN�EAL Attach(2)Plot Plans;(2)sets of Building Pians;(1)set f Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities 81 dumpster;Site Work Permit for s bdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life S ety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for al new projects.All commercial requirements must meet compliance <br /> SIGId PERMIT Attach(2)sets of Engineered Plans. <br /> °'"'PROPERTY SURVEY required for all NEW construc ion. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 5�500,a Notice of Commencement is required. (A1C upgr des over 57500) <br /> "" Agent(for tfie contractor)or Power of Attomey(for the owner)would b someone with notarized letter from owner authorizing same <br /> OV�R THE COUiVTEIR PERMITTIPIG (Front of Appiication Only) <br /> Reroofs if shingles Sewers Senrice Upgrades A/C Fences Piot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />