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-- _. <br /> , --_ _.-- <br /> �` s�a�so-oo2a City of Zephyr�hiiis Perrnit Appiication �ax-813-784-4021 <br /> Buiil ing Department <br /> Date Received phone Contact for Permitting -- <br /> nnnet � � a � itea � <br /> Qwner's t�ame \!'�S'� '�'��pL�j/� � Owner Phone i�umber (� ��'(�.q[ �j� j �t I <br /> Owner's Address `�- ! �t� p'Z'1 p{�(`� k.J('.( Owner Phone Number �� _---` <br /> Fee Simpie Titiehoider Naene � I � Owner Phone Number � � +� <br /> ( <br /> Fe�Simpie Titiehoider Address ` I <br /> JOBADDRESS S�� t"O Xt�✓1C}t9�I �C• LOT# �— <br /> SUBDIVi510N �---� � PA �EL 1D# <br /> � (OBTAINED FROM PROPERTY TAX NOT1GEj � <br /> WORK FROPOSEp lVEW CC7NSTR AD lALT � SIGN � � DEMdL{SH <br /> 1NSTA�L. RE�AlR <br /> PROPOSED USE � SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION � SLOCK � FR,dtVIE � STEEL � <br /> DESCRIPTION OF WORY. / 7 �--^�I��'l, ��(/L�l � �/l 1 jC�l/��� tM � ! 1�� � S M <br /> � <br /> BUILDii�G SIZE �— `� SQ FOQTAGE� I ,� HEtGHT ��� � <br /> u°a <br /> �BUILDING �� VALUA�ION QF TOTAL CONSTRUCT(ON <br /> DELEGTRtCAL $ AMP S�RVICE � PROGRESS ENERGY � W.R.E.C. <br /> OPLUMBING ���� ��� <br /> ECHANICAL $ VA�UAT{ON OF MEGHANlCAL INSTALLATI�N � <br /> �� s �dC� <br /> �GAS � RQOFING CJ S ECIALIY � OTHER ��� �S' <br /> FINISHED FLOOR ELEVATiONS F OOQ ZQNE AREA �YES NO � �,� ! <br /> . . . . <br /> � BUIL.DER CONYPANY <br /> SIGNATi1RE REGISTERED Y/ N PEE CURREA Y!N � <br /> Address ( License# �--- ----` <br /> ELECTR1CiAN � COMPANY <br /> SIGNA7URE REGISTERED Y! N FEE CURRE� Y/N <br /> Address i LiCense� � ++� <br /> � <br /> PLUNiBER � COMPANY <br /> SiGi�ATURE � ( RCGIS7ERED Y/ N FEE CURRE� Y i N <br /> Address ( Lice�se# ��---'--�—� "� <br /> _._.��,,....c j, p <br /> MEGHANICAL �. /,��., _— COMPANY I ��1�°�'i �(� i ��ila� ��'^� <br /> SlGNATURE I REGISTERED / N FEE CURREh Y/N <br /> Address �� ""t � i 1J � License# �� �U�� L L�(i� <br /> OTNER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREh Y!IJ <br /> r--- <br /> Address I ' License# � <br /> - 88fi811 ! ! Al111@0 ➢ I116tg16 ➢ H � i6 � 1i � 44N9111dIfliE4 & dl ! l106lIiIIYA � libde0l <br /> RESIDENTiAL Attach(2)Piot Pians;(2)sets of F3uilding Pla�ns,(1)set of Energy Forms;R-O-W Permit for new constrvctton, <br /> Minimum ten(10}woricing days aiter submit{al date. ftequtred onsite,Construction Plans,Siormwater Pians w!Siit Fence instaAed, <br /> Sanitary Facilities&1 dumpster;Site Work Permi#for subdivisions/iarge projects <br /> COMMERCiAL Attach(3}compiete sets of BuiVding Pla�s p us a Lite Safety Page;(1)set of Energy Forms R-O-W Permit for new construclion. <br /> Minimum ten(10)wor{cing days after submit ai date. ftequired onsite,ConsUuction Plans,Stormwater Plans w/Silf Fence instaliecS, <br /> Sanitary Facilities&1 dumpster.Site Worlc!Permit for ali new prajects.R41 commercia4 requirements must meet compliance <br /> SIGN PERMIT Aitach(2)sets of Engineered P4ans. ` <br /> *"""PROPERTY SURVEY requirad for ai{N�W constructian. <br /> . . e <br /> Directions: 1 <br /> Fil1 out applioation compietely. <br /> Owner&Contractor sign back of application,notarized <br /> if over$2500,a t�otice of Gommencement is required. (AIG upgr�des over$75QOj <br /> •* Agent(for the contractor)or Pawer of Attomey(for the ovyneP)wouid be someane with notarized letter from owner authorizing same <br /> OVER TNE GOUNTER PEFtMITTING (Front of Appiicati�on Oniy) <br /> Reeoofs if shingies Sewers Service Upgrades AlC� �ences(P1ot/Survey/Footage} <br /> Driveways-Not over Counter if on public roadways..nee�s ROW <br />