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n��-�a�-W�U Gity ofi Zephyrh`rtts Permit Applica#ion Fax-813-780-002'! <br /> BulEding Departmen! <br /> Dats Reaelved ` ` <br /> Phone Contact for Permittin <br /> t'�wner's Naene;. ° � :" _. - Owner�hone Nurnber ' .�,�� / ��� <br /> �= _ ��f� � .. .,.� ;...:�:_��..�__._Y... �.� �. �..�. � <br /> Dwner's Addre�s;' �• :�.'2:°��Dinmer�Phone Number <br /> ,'.,..... .,' ( ' .. :J:'�, ,i <br /> ' . ..R-.,:.- , r�.� c.•.. ..�<�. ..�^..,. �.,.._.- .-_ �` .. ' . _.. ' . :�:,- . <br /> A.,�...,, . ri <br /> .,e,..., . "' .:. ; y <br /> Fee Simpte'4'itleholder Warne � ,.;,.,OyimerPhone+Mumber <br /> Fee Simpie 7iNeholder Address <br /> 10B ADDRESS �-�}�=1/t'Y�..' - LOT# � <br /> _� <br /> SUBDlVIS{ON �� � PARC�!fD# .l ' • �! ° C�� U � �C�� C�J�Q <br /> ,_ ___.__(OBTAINED_FROMPROPER?YSAXMQTIGED--- -- - - - ----_--- - ' - <br /> ._ �__.,._ -- _. _ <br /> - -- ___---- - - _.._-�._ ____ _ .___ <br /> WORK PROPOSED e NEW CONSTR� ADD/AI.T � 81GN [,� Q DEMOLISH <br /> 1NSTALL REPAiR <br /> ; <br /> PROPOSEp USE Q SFR Q COMM ." [� OTHER <br /> TYPE OF CON3TRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESGRtPT10N QF WQRK PY� � � 1 � <br /> BUILDING SlZE ���� S�F007AGE�� liEIt3HT <br /> QBUILDING $ � VAl.UATION OF TOTAL C01�4S7RUCTtQN <br /> QEl.EC7R�CAL �9i --� AMP S6RViCE Q PROGRESS ENERGY [� W.R.E.C. <br /> � <br /> QPLUMBING �—r� f�'� V <br /> � �� <br /> �MECHANICAG $ VALUATION OF MECHANtCAL INSTALLATiQN <br /> �? � � <br /> [�]GAS Q ROOFING [� s��cracrv C] OTHER <br /> =1RliSNED FLOOR ELEVATiONS �� FLOOD ZONE AREA QYES NO <br /> 3UILDER COMPANY <br /> �stGNATUitE REG�STERED Y/ N FEE CURRE� Y/N <br /> Address �lcense# ������ <br /> =_LECTRtC1AN COMPANY <br /> 3i�NATURE REG�STERED Y/ N FEE CURRE� Y J N <br /> Addre�s �Icensa# � ����� <br /> �LUM9ER � � COMPANY <br /> 3tGMA�'URE REG[STERED Y/ N FEE CURRE� Y/N <br /> Address l.lcense# ��i `� <br /> � <br /> AECHANlCAt `? � COMPANY � _ <br /> 3lGNa7URE ' ' �'"`�"� REGlSTEREO Y (+! FEE CURRER <br /> Address �.� � � 1 License# ����, Q�,) / � <br /> �THER COMPANY <br /> ZlGNATURE REGtSTERED Y! N FEf CURREA Y 1 N <br /> Address Ucense# ��� ��� <br /> tESiQE#ITtAL Attach{2)Pfot Plans;{2)sets of Build3ng Plans;{1)set of Energy Fortns;R-O-W Permit for new canstructian, <br /> Minimum ten(10�working days after submlttal date. Requlrsd onslte,GonstrucUon Plans,Stormwater Plans w!Sfli Pence Installed, <br /> Sanitary Facilitles&1 dumpster,Sike Work Permit for subdivisionsAarge projects <br /> :OMMERCtA� Aftach{3)asmptete sets of Butidtng Ptans pius a Life Safety Page;(1}set af Energy Forms.F2-O-W Permit for new cons#ruction. <br /> Minimum ten(10}working days after submfttat date. Reqaired onslte,Constru�tion Pians,Stormwater Ptans wi Sitt Fence instailed, <br /> Sanftary FaciliNes&1 dumpster.Site Work Permit for all new proJects.All commerclal requirements must meet compllance <br /> ;iGN PERM17 Atfach{2)se#s ot Engtneered Pians. <br /> "'"PRQPERTY SURVEY required for a!I NEW construcUan. <br /> )irections: <br /> FN!out appltca8on c�mpletely. <br /> Owner 8�Contractor s(gn back of applicatlan,notarized <br /> if over�2500,a Natice of Commencement is requlred. (AIC upgrades over;T500) <br /> ' Agent(far the contractor}ar Powar of Attomey(for the awner)wouid be someone wikh notarized letter from awner authorizing same <br /> 1VER Ti�iE COUNTER PERM11TiNG (Front of Appitcatlan Onty} <br /> I ;eroois!(shfngles Sewers Servlce Upgrades R!C Fenaes(PtoUSurveylFootage} <br /> '� Driveways-Not over Counter if on pubtic roadways..needs ROW <br />