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a�aaso-oo2o City of Zephyr lills iPermit Application Fax-813-780-0021 <br /> Buildiing Department <br /> Date Received'" S I �� 3 � � — �C°3 �r7 <br /> � Phone Co tact f,or Permitting <br /> ^ ' S� �9� � <br /> Owner's Name �' 1 � � Wl t/1/l I Owner Phone Number <br /> Owner's Address l� �� 1 U"� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> I I <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � �CD �� � LOT# � <br /> SUBDIVISION P CE�ID <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NSTALLSTR e R PAIR � SIGN Q Q DEMOLISH <br /> PROPOSED USE Q SFR Q C MM �,� OTHER v, �-� <br /> TYPE OF CONSTRUCTION Q BLOCK Q F ME� 0 STEEL Q v <br /> DESCRIPTION OF WORK � o`.S� 4�� I �� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> i � <br /> OBUILDING $ VALU TIONI OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP ERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> �CHANICAL $ VALU TION OF ECHANICAL INSTALLATION ����� <br /> I �� <br /> QGAS Q ROOFING Q S ECIiLTY � OTHER � <br /> FINISHED FLOOR ELEVATIONS F OOD ZONE AREA QYES NO <br /> � <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> I I <br /> Address I License# <br /> ELECTRICIAN COMP I Y _ <br /> SIGNATURE RE�ISTEIRED Y/ N FEE CURRE� Y/N <br /> Address I I License# <br /> PLUMBER C IMP I Y <br /> SIGNATURE RECSISTERED Y/ N FEE CURRE� Y/N <br /> i i <br /> Address I I License# <br /> � ,. <br /> MECHANICAL COMPANY �2✓►"�p,�' .�" � ��1 . <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � �� � � /�.� I I License# <br /> OTHER C IMP I Y <br /> SIGNATURE REGISTEIRED Y/ N FEE CURRE� Y/N <br /> I <br /> Address I License# <br /> i � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;( )setiof Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal d e. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Perm t for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a ife Safety�Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days'after submittal d e. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Perm t.for all ne�projects.All commercial requirements must meet.compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. ' � � - <br /> `�`"PROPERTY SURVEY required for all NEW nstru�tion� . , <br /> Directions: � <br /> Fill out application completefy. � <br /> Owner&Contractor sign back of application,notarized � <br /> If over$2500,a Notice of Commencement is required. (A/ upgrades over$7500) <br /> "" Agent(for the contractor)or Power of Attomey(for the owner)w uld tie someone with notarized letter from owner authorizing same <br /> OVERTHECOUNTERPERMITTING- �..-�(Front�of�Applicafion'Onl ) �I '� _ „..,,_:,. r =-., ;— -•• ° <br /> Reroofs if shingles Sewers � Service,Upg�ades A/C F nces�,(PIo�Survey/Footage) ' _ ' <br /> Driveways-Not over Counter if on pulilic roadways.,needs RO �I ' ; r ' � <br /> . „- - ° _� _ .� �i. ' i - - - - - • -. ,..-. _�. ': <br />