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�,:s-�nu-uvzu City of Zephyrhi'Is Permit Application Fax-813-780-0021
<br /> Buildin�Department
<br /> Date Recetv�d ` Phone Contact for Permttting 0� /,� – ���
<br /> Owner's Name �N G Owner Phone Number �j3 (> ,�
<br /> Owners Add�ess (� .� f Owner Phone Number
<br /> Fee Simple Titleholder Name Ovvner Phone Number
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<br /> Fee Simple Tttleholder Address
<br /> JOB ADDRESS • � �� C� � x
<br /> LOT# ..
<br /> SUBDIVISION PARCE ID# -
<br /> --- - - - (OBTAINED FROR9 PROPERTY TAX NOYICE) - - - " l '
<br /> WORK PROPOSED B NEW CONSTR B ADDlAL Q SIGN Q Q DEMOLISH
<br /> INSTALL � REPAIR
<br /> PROPOSED USE Q SFR Q COMM Q OTHER
<br /> TYPE OF CONSTR�CTION � BLOCK Q FRAME Q STEEL Q �
<br /> DESCRIPTION OF WORK � � � �
<br /> �
<br /> HUILDING SIZH �G v SQ FOOTAGE ��� HEIGHT �J
<br /> QBUILDING $—1 Z���Q� VALUATION OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVIC Q PROGRESS ENERGY [� W.R.E.C.
<br /> OPLUMBING $
<br /> ����
<br /> OMECHANICAL $ VALUATION � F MECHANICAL INSTALLATION �'��
<br /> QGAS ��_ ROOFING Q SPECIALTY 0 OTHER
<br />' FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES �
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<br />' BUILDER �� �/ CO�PANY GL ,/� TJ�z' ��,�
<br /> SIGNATURE �'2��!G � �U 6� 'REGI�TERED Y/ N FEE CURRE� Y/N .
<br /> Address License# C� � C1
<br />� ELECTRICIAN CO PANY
<br /> I SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N
<br /> -
<br /> Address Ucense# '
<br /> PLUMBER � CO PANY �
<br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N
<br />� Address License#
<br /> I MECHANICAL COMLPANY
<br /> I SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � License#
<br /> OTHER � CO PANY
<br /> SIGNATURE - Re�l Terteo Y J N FEE CURRE� Y/N
<br /> Address I License#
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<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set o�`Energy Forms;R-O-W Pertnit for new constructlon,
<br /> M(nimum ten(10)working days aftersubmittal date. Required onsite,Constructlon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Faciflties 81 dumpster,Site Work Permit for subdivislonsAarge proJects
<br /> COMMERCIAL Attach(3)complete sets of Buildfng Plans plus.a Life Safety Page;(1),set of Energy Forms.R-O-W Permit Tor new constructlon.
<br /> Minimum ten(70)working days after submittal date. Required onsite,Construction Plans,Stormvirater Plans w/Silt Fence installed,
<br /> Sanitary Faclllties&1 dumpster.Site Work Pertnit for all new proJects.All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Engtneered Plans.. � � " -
<br /> '"'"PROPERTY SURVEY required for all NEW construc on.
<br /> Dtrections:
<br /> Fill out appi(catlon compietely.
<br /> Ovmer&Contractor sign back of applicatlon,notarized I
<br /> If over 52500,a Notice of Commencement is requlred,, (AIC upgra_es�over 57500) - . , .. -._ , r.�.._--, r,..D �._ .:.-,... �
<br /> " Agent(for the contractor)or Power�of Attomey(for_the owne�):would`tie'sortjeone with notarized letter from ow�er authorizing:same- -��=-�� , '
<br /> _ . N;t; r
<br /> OVER THE COUNTER PERMITTING ` (Fro`nkof Application On�ly);, -'' �` a � , . �, , '� _ _ =?
<br /> , :.:,, ;.
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<br /> Reroofs ff shingles Sewers $ervice:Upgrades;AlC`:,,��„ Fences•,(„Itft/$urvey/Footage) � ..,. ,. ,. , �-
<br /> � , .._ ._ ;.. .._�._...,.�_.4...�_.�..,. .,.: <.�.,�. .._ . . ,�.. ._ ,.... ..�,. ,...M...... .;
<br /> Driveways-Not over Counter if on pubitc roadways..needs ROW
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