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813-780-0020 City of Zephyrhi fs Permi#Application Fax-$1a•78o-oaa�
<br /> Buildin Department
<br /> Date Received c~ � Phone Contact f r Perm(tk4ng —
<br /> Owner's Name ��✓%/��/� Owner Phone Mumber ��� "���''����'
<br /> Qwner's Address i� ��� ��2.5" ' �i''�y/ Owner Phone Number �! I
<br /> Fee Simple Titleholder Name - Owner Phone Numbsr �� �
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRfSS . � ��� � `�%��'�'`��j`1--5 ��!/ �l LOT# ��
<br /> SUBDIVIStON � � PAFtCE IC3#
<br /> - -- - - -- ---- — --�__---,�-- --°- --� _ _ __._ _.�-- -. ., . —(067AINED'FROM'RFt.ZPERTI(TAX'NOTICE)__-_ __ – -- ----
<br /> WOft!(PROPOSED � NEW CoNSTft ADDIAL � SIGN Q Q DEMOLISH
<br /> � INBTALL � REPAIR , .
<br /> PROPOSED lJSE Q. SFR.� Q COMNt � OTHER
<br /> TYPE UF CONSTRUCTION Q ; B4.00K Q FRAME � STEEL � �
<br /> DESCRIP710N OF WORK � � 4� � d� � !!/'�����,f'/s T!!�c �G�I�,,�-t—°-��f�i�-
<br /> BUitDING 5lZE �--�i�� � SQ FOOTAGE G� `� HE1fiFiT ����� '
<br /> 0$������� �� I VALUATION OF TOTAL CONSTRUGTION
<br /> �._J
<br /> QEl.ECTRICAI. �$> � AMP SERVI E Q PRqGRESS E1�4ERGY Q W.R.E.C.
<br /> L
<br /> OP�ISMBING �— S
<br /> �
<br /> [���,�'Ei+IECFtAN(CA� $ VALUATlQN OF MECHANlCAL IiVSTALLATfORI ���t
<br /> �� �
<br /> QGAS [� ROOFING Q SPECI TY � OTHER
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA [,��YES NO
<br /> su��o�� � c MPANY ._:5�����'� ��.�' f�'?L��
<br /> 51GNATURE `;�'Z__ �r'°� Re ISTERED Y/ N FEE CURRE� Y!N
<br /> Address �Ct���f ,,����✓�°�.� .✓ License# C�1"�d v�c�'"l�j`Z�
<br /> ElEGTRIC4AN � C MPANY
<br /> SIGNAI"URE RE IS7ERED Y/ N FEE CURRE� Y/N �
<br /> Address License# �_ �.
<br /> Pl.UMBER � � C MPAtdY -
<br /> SIGNATURE RE ISTERED Y/ N FEE CURRE� Y J N '
<br /> Address l.lcense# �� ��
<br /> MECHANtCAE. � . C MQ�ANY "
<br /> 81GNA7URE. � RE IS7ERED Y/ N FEE CURRE�. Y J N
<br /> Address License# �� � �
<br /> OTHER C MPA�lY
<br /> SIGNATURE R GrsTeRED Y J tV . FEE CURRE� - Y J N
<br /> Address �lcense# �� �
<br /> RESIDENTIA� Attach{2)Ptot Ptans;(2)sets of Building Pians;{1}se of Energy Forms;Fi-O-W Permit for�ew construction,
<br /> Minimum ten(10)working days after submittat date. equired onsite,Construction Plans,Stormwater Plans w/Silt Fence instatied,
<br /> Sanitary Facilities 8'1 dumpster,Site Work Permit for ubdivisionsAarge projects
<br /> COMMERGIAL Attach(3}compie#e sets of Building Plans plus a Life afety Page;(1)set of Energy Fattns.R-O-W Permit for new constructton.
<br /> Minimum ten(10)working days after submittal date. equired onsite,Constructian Pians,Stonnwater Pians w1 Siit Fence instatied,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit for II new projects.All commercial requirements must meet compiiance
<br /> St�N PE�2MtT Attach{2}sets of Englneered Plans. , . . - '� ; , . -
<br /> """PROPERTY SURVEY required for all NEW cons ctton. '
<br /> Directions: �
<br /> Fill out application completely..
<br /> Owner 8 ConUactor sign back of application,notarized
<br /> tf over�25Qd.a Notice of Commencemen#Fs required. {AiG up rades over�750q}
<br /> *A r:.....:,,.y� � � . . - _ r,..i.:'..-...,
<br /> Agent(for the contractor)or Power of Atti3rimey'(for"the oVuner)�wa�Id b'�someone with notarized letterfroin owner autlioriiing same'°'?, ,,,;.� ''"':'.
<br /> 43 ., ;;•. � � .. ,. � ' �: i:
<br /> OVER THE COUNTER PERMI`CTI�IG s,�;r:{Frorit of Applicatian.t3'rily},`':,r � _ � , ,,� - ,;
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fenc` `��PlatlSurvey/Footage) �_ ' . •�: , - � !`''• '
<br /> yu���„ � - �y 'j . , _,. � . .�,,.���.,�, .a,�. ° `a.
<br /> Driveways-Not over Gounter ifii�i'pu6lic r`oadways::ri��s`RDW" � ' .. Y a__ �. , ..� . ,.z. .�,.._ � -�_... „, .,._:.
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