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, 813-780-0020 City of Zephyrhi Is Permit Application Fax-813-780-0021
<br /> Buildin Department
<br /> r -
<br /> Date Received
<br /> PFione Contact fo Permitting —
<br /> Owner's Name U L�� ` � Owner Phone Number "
<br /> Owner's Address S ��Es� � //�� r Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS •� _ LOT# C�
<br /> _,.
<br /> SUBDIVISION PARCE ID#
<br /> � (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e NEW CONSTR B ADD/AL , 0 SIGN 0 � DEMOLISH
<br /> INSTALL REPAI,4 "
<br /> PROPOSED USE Q SFR Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK � ( IT�J C �t a� �G
<br /> BUILDING SIZE ' SQ FOOTAGE HEIGHT
<br /> OBUILDING $ VALUATION F TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVI E Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ �G
<br /> , � �5�
<br /> OMECHANICAL $ �Q �f � VALUATION F MECHANICAL INSTALLATION
<br /> l
<br /> QGAS Q ROOFING Q SPECIA TY 0 OTHER
<br />, FINISHED FLOOR ELEVATIONS FLOOD ONE AREA QYES NO
<br />; BUILDER CO PANY
<br /> SIGNATURE REG STERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> I ELECTRICIAN CO PANY
<br /> SIGNATURE REG STERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> PLUMBER CO PANY
<br /> SIGIdATURE REG STERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> MECHAfdICAL CO PANY / Ns' ��N�
<br /> SIGNATURE REG STERED Y/ N FEE CURRE� Y/N
<br /> Address License# �
<br /> OTHER CO PANY
<br /> SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N
<br /> Address - License#
<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set�f Energy Forms;R-O-W Permit for new construction,
<br /> Minimum ten(10)working days after submittal date. R quired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciNties&1 dumpster;Site Work Permit for s bdivisionsAarge projects
<br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life S�fety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. R quired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilittes&1 dumpster.Site Work Permit for a I new projects.All commercial requirements must meet compflance
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans.
<br /> •'•"PROPERTY SURVEY required for all NEW constrv tlon.
<br /> Directlons:
<br /> Fill out applicadon completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> !f over 52500,a Notice of Commencement Is required. (A/C upgr des over 57500)
<br /> •' Agent(for the contractor)or Power of Attomey(for the owner).would b someone with nota�ized letter from owner authorizing same
<br /> OVERTHE COUNTER PERMITTING�� "� ';�(F�ont'ofApplica.tion'Qnly) ,_,,,, :
<br /> Reroofs if shingles Sewers Service'Upgrades A/C� Fences(PIoUSurvey/Footage) �.,�,,.:.<�_�..•�• --•>- -° _,�` ' `" • "
<br /> �; - ,, s�• _ , _ �
<br /> ., , , _ ..r . . .
<br /> � � '- "-� • •' , , =4
<br /> Driveways-Not over Counter if on publio,roadways::needs:ROW � ` ` � �, � ' ° �' " - _�
<br /> �;
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