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a,a-,��,�� c:ity of Zephyriiiil Permi#Application Fax-813-780-0021 <br /> Bullding epartment <br />�i Date Recelved ` phone Contact for ermlkttng - <br /> Dwner's Name 'p'� h�l �l"�I�Cqivner�Phone NumberM� '�J'�' �7 Y <br /> �.... . . . _. .. i �-.''t �`'.: :..'1.l: ���'4��-' . � <br /> ,`. _ .... _. . . .. �, , - c . .t;' 's �!S iJ.i7i.�i ` <br /> Dwner's Add�ess 3�r�° d``�1 ���is'tiJr�� �/e. Owner,Phone Number; � <br /> { :.. , .. . � . . ..,. . , : �� ;,_ ti°,",:�:_�_.,.....,;:::.q..�;�`-.:�.;��..._ � � <br /> Fee 5impie TitletiolderName� Y�%��'7T�.:��r.,f�.G��r Uwner Phone Number `�'�rr`- <br /> Fee Slmple 7itlehalder Address <br /> JOB ADDRESS ��r%� �-r�n S i n �v�. �� r 1 i i� 3'.�Sr{2.- E.OT# l�I <br /> � <br /> SUBL?!1/IS11�N �` �� �o��w �d�� PARCEL 1 # <br /> _ _ _ _ `(09TAINED FROM PROPERTY__TAX NOTICE)__�vy_ �_u��_ --_ <br /> WORK PROPQSED -- - ---- NEW CONSTEt - - AQD/ALT = � SIGN Q _ Q DEMOZtSH <br /> e Ii�STALL 8 REPAiR . <br /> PROPOSED USE Q SFR Q COMM ; �� OTNER <br /> TYPE OF Ct�NSTRUCTION Q BLOCK [� FRAME � STEEL Q <br /> DESCRIPTtOF!OF WORK �� c.c�c� � �i ir�o u�� �c��' , <br /> BUtCDING StZE fZ X� �� � SQ FOOTAGE ��Q liE1GHT g � � . <br /> QBUILDING S � ?��O p p � VAI.UATIQN O Tt3TAl.GOR�STRUCT10i�1 <br /> QELECTRICAI $ �� AMP SERVIC . Q RROGRESS EIVERGY � W.R.E.C. <br /> QPLUMBING (y�� ' - ���� <br /> � - • ,,�C1 <br /> QMECHANICAL $ - - -- J VALUATION O �MECHANICAL INSTALlATION <br /> QGAS Q ROOFING Q SPECIAL � OtHER' <br /> =SNISHED FLOOR ELEVA710NS �� FIOQD Z NE AREA QYES NO �r_,.._ . <br /> � <br /> ���. <br /> 3t11LDER f COM ANY R 3'Y'iLs,- � '�jY� . <br /> 51GNATURE RE��s�ED Y/ N FEE CURRE� Y/N <br /> Address t.Ecense# ( �� <br /> °_l.ECTRICIAN � COM ANY <br /> atGNATUFtE � REGtS RED Y/ N FEE CURRE� Y I N <br /> Address �Ecense# � �� <br /> �L.UMBER COM ANY <br /> 3I,�'�rNA'�URE � , - .,,, � l2EGt RED Y I N FEE CURRE� Y/N <br /> Address , l.tcense# �— � <br /> AECHANICAL � • 'r' COM ANY <br /> iiGNATURE REGt RED Y t N FEE CtlRRER Y 1 N <br /> Address l.fcense# � � <br /> )THER � COM ANY � <br /> ti�NATURE ttE�� Re� � Y! N FEE CUi2RE� Y!N <br /> Address l`Icense.# �^ � <br /> tESiDENTIAL Attach(2)Pfot Plans;(2)se#s of Building Plans;(1)set of Energy Farms;R-O-W Permit for new construc8on, <br /> . Mirtimum fen{10)worktng days after submtttal.date. fteq Ited onsite,Cons#ntc@on f'Ians,Stormwa#er Plans wl Slit Fenc�Installed, <br /> Sanitary Faciiitles 81 dumpster;Site Work Permlt far.su dlvislonsliarge proJects <br /> :OMMERCIAL Attach(3)complete sets of Building Pians plus.a Life Saf ty Page;(1)set of Energy Forms.R-O-W Permit for new constnuctlon. <br /> Miniroom ten(40}workiag days after submitta!date. Req Ired onslte,Canstructiatt Pians,Stormwater Rtans wl Sltt Fence lnstatled, <br /> Sanitary Factlfties&1 dumpster.Site Work Permit for all �ew pro)eots.All commerclal requlrements must meet cnmpliance <br /> cIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PRQFERTY SURVEY requlred for a11 NEW construcU n. <br /> ►irectiona: <br /> Filt out appllcaUon completely: <br /> Ovmer 8 Contractor sign back of appllcallon,notarized . <br /> It over 3250q,a Notice ot Commencement is reQuired. (AIC upgra es over�7500) <br /> ' Agent(for fhe contractorj or Power of Attomey(for the owner}would be omeone with notarfized letter from owner authorizing same <br /> IVER TNE COUNTER PERMITTING (Front of Applica8on Oniy) <br /> teroofs if shingles Sewers Service Upgrades AtG Fences{ IotlSurveyJPoa#age} <br /> Driveways-Not over Counter lf on public roadways..needs RiJW <br />