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8�3-.��-�,LU C:ity of Zeph rhitis Per'mit Application Fax-813-780-0021 <br /> Bu Iding Qeparkment <br /> Qats Received Phone Conta t for Permittin ��� ~ I� s�.� <br /> Dv+mer's Namg�,.._ ..S�.IfL 2. �'{' � �l,l� �`J�f 1 Q Chn+rter�Phone Number ,, �,�J' "� v �� �I I J <br /> D�vners Addres's� ����''�'� {�-���'Y� �v� �. 'Owiier Pfione Nuinber; � � <br /> � ;i �,,.�' � -_ '-.,, ',_4;• y •..:.'�.�-�t`":_f���;:-`..'S„,•- �� � <br /> Fee Simpte Titlehalder Nattie„�.�`, . .I. , _Owrier..Rhone,Nomher. <br /> Fee SfmpFe''t'itieq�o�er Address � " <br /> JQ8 ADDRESS �t/ !��° ��'` - �OT# � <br /> ,�,.�.�,� ., . .��; r „ ,.. - _,. .. ..-. . .. ,.. . . <br /> 5U8DIVISION �`, ' ' ..�. J- .� -� PA E!ID�! ��+""��~'_�'i'� l�� �I p. ��S C��—� P �7� <br /> _ _ �- _ -_ �. _ — . - --- - - -- --- ----- - (OBTAINEDFRQ�M11PRYfPERYYTAICNOTICE)'__ � _�_�. _ ---- - -/ <br /> ��(''� .�� <br /> WORK PROPOSED I �/I NEW CONSTR� ADDJALT Q SIGN Q � qEMOLISH <br /> Q ifidSTALI REP" iR <br /> PROPOSED USE � SFR � CO�M � OTNER <br /> TYPE Of�.ONSTR�JCTION Q B�.00K Q FRA E � STEEL CJ <br /> DESGRlPTIQN OF WORK U Gl/�� �do� a YC C��e�� d� <br /> BUILDING 81ZE � � SQ FOOTAGE FIEIGIiT � � <br /> QBtiILDiNG ` � �"��� G VALUAT ON OF TOTAL GONSTRUCTI4N <br /> � -t <br /> QELECTRICAL ($�� AMP SE VICE Q PROGRESS ENERGY Q W.R.E.C. <br /> L <br /> QPLUMStNG $ �. S���o <br /> QMECNANiCA� $ VA1.UAT ON OF MECHANtCAI INSTALLATION <br /> � � <br /> C]�AS � +�oa�:�v� Q s� ci,�.zv 0 o���t <br /> =tAIISHEd FE.00R EIEVATlONS C�� FL OD ZONE AREA [�YES NO <br /> 3UILdER COMPANY <br /> �IGNATURE REGI57ERED Y! t�i FEE CtlRRE� Y/N <br /> Address License# �� �� <br /> 'cLECTRtCtAN COMPANY <br /> a1GNATUl2E REGISTERED Y I N FEE CURRE� Y/N <br /> Address Ucense# � i� <br /> �LUMBER Ct)MPANY <br /> 3lGI�ATURE REGiSTERED Y t N FEE CURREP Y t R! <br /> Address License# �— ��� <br /> AECFfA1+ftGAL � Cf3MPANY <br /> iICsNATURE - RE�ts�REO Y/ N FEE CURREt� Y!N <br /> Address �. " �� License# � � � <br /> . . _ <br /> )TNER d�� '�-�--�-/� COMPANY <br /> i1GNATURE G'e a�lilp '�"� REGISTEREQ Y! N FEE CURREA Y/N <br /> Addrass �.icense# � `�� <br /> tESIDENTIAL Atkach(2�plot Plans,(2)sets of Building Plans;(1j et of Energy Forms;R-0-W Permtt fof new construc8on. <br /> Minimum ten(10)working days after submittal date Requlred onsite,ConstrucUon Plans,Startnwater Plans w!S(It Fence InstaAed, <br /> Sanitary factlittes&1 dumpster;Site Work Permit r subdivlslonsAarge projects <br /> :OMMER�IAL Attach{3}complete sets of Bnitding.Ptans pius a�i e Safety Page;(1)se#of Energy Forms.R-O-W Fermit for new canstructton. <br /> Minimum ten(10)working days after submittal date Required onslte,Canstructlan Plans,Stormwater Plans w!S!!t Pence}nstalled, <br /> 5anitary Facitities&f dumpster.Stte Work Permit r a�l new pro)ects.All commerclal requirements must meet compliance <br /> ;lGM PERMIT AEtach{2}sets of Engineered Plans. <br /> ""•"PROPERTY SURVEY requlred for al!NEW con truc8an. ' <br /> lirectfons: <br /> Fill out application completely. <br /> Ovmer&Contractor sign back of applicaflan,noterized <br /> !f over�2500,a Na#Ice of Cammenaement is requtr�d. {A!C grades over s7500) <br /> ' Agent(for tfie corttractor}or Power af Attomey(for the rntmer}wa !d be someane wtth natarized ietter ftam owner autharizing same <br /> lVER TNE COUNTER PERMlTTIPlG {Front of ApplicaUon Onty) ,, <br /> ;eroofs tf shingl�as Sewers Sarvlce Upgrades A/C Fen es(PIoUSurveylFootage) �• " � � <br /> Driveways-Nat over Counter if an pubiic roadways..needs ROW <br /> � <br />