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813-780-0020 City of Z phyrhilis Permit Application Fax-813-780-0021 <br /> , ;;,f � Building Department <br /> Date Received Q <br /> Phone ontact gor Permitting UL.� Z�o� -- ���� <br /> ' Own�r's R1ame G/ � r b � �`� ��"" Ovuner Phone V�uresber . . -r c � v---- <br /> Ouvner's�ddress � /•�/ � ° ��!'��r �. � � Oven�r Phone Pdumber <br /> Fee Si�ple Titleholder�dame ; Ovuraer Phone Wummer <br /> Fee Simple Titleholder Address <br /> I <br /> �o��►o���ss � g�/ �!�'�°l �-1 �Iuc� � f1 �Ii`4S � �o�r# �l <br /> su��i�isio� ��►RC��.io# a_� c��P � O1�00 ('d./�D ���� <br /> (OBTAItdED FROM PROPERTY TAX fdOTICE) <br /> WORIY 6'ROPOSED NEW CONSTR ADD/ALT 0 SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> �ROPOSED U�E SFR Q COMM � OTHER <br /> �V����COMSTRIDCTIOfd Q BLOCK Q FRAME 0 STEEL Q <br /> D��C�I�TIOM OF!RlOR{S �� ���� �--°' D� ' v 2 , <br /> OUILDIV�G 51ZE S(d FOOTAG � HEIGF9T <br /> OBUILDING $ V LUATIONI OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ A P SERVICE 0 PROGRESS EfVERGY Q W.R.E.C. <br /> �PLUMBING $ <br /> OMECHANICAL $ V LUATION OF MECHANICAL INSTALLATION � '�� <br /> _�$�j3,Gf � � <br /> QGAS Q ROOFING Q SPECIALTY � OTHER � � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �v�� <br /> BUIL.DER COflflPAPlY <br /> SIGR�ATURE REIGISTERED Y/ N FEE CURRE� Y/M <br /> �address � License# <br /> I <br /> �L�C�'6tICIAf� CORAPAfdY <br /> SIGVN�4TU12E REGISTERED Y/ N FEE CURRE� Y/N <br /> �,ddPess I License# <br /> I <br /> �LUflflBER COIlAPAR1Y <br /> SIG�'ATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> �ddress I License# <br /> ��ctaa��ic�� , � cl���,r�v H��f S �r�AR��2 <br /> SIGWP,TU�2E � REGISTERED Y I N FEE CURRE� Y/N <br /> e�ddress � License# (�7"� ��7' <br /> I <br /> pT�p�� CORAPr4MY <br /> SIGft1�4TURE REGISTERED Y/ N FEE CURRE� Y/N <br /> B�ddress I License# <br /> R�SIDERITIAL. Attach(2)Plot Plans;(2)sets of Building P ans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> ---_ -- Sanitary-Facil;t!as-�1 dumpster;-Site Work P-ermit_for�subdivisions/large.projects____` _ <br /> COfHi�fiERCIAL Attach(3)complete sets of Building Plans lus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after subm ttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Wor Permit for all new projects.All commercial requirements must meet compliance <br /> S9Gh��ERMIT Attach(2)sets ot Engineered Plans. <br /> OAMwPROPERTY SURVEY required for all EW construction. <br /> �irections: � <br /> Fill out application completely. <br /> Owmer&Contractor sign back of application,notarized <br /> If over�2500,�fdotice of Commencement is required (AIG upgrades over$7500) <br /> "° Agent(for the contractor)or Power of Attomey(for the o er)would be someone with notarized letter from owmer authorizing same <br /> ONER YHE COUfdTER PERIIAITTIMG (Front of Applicati n Only) I <br /> Reroofs if shingles Sewers Seroice Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Drivevuays-fVot over Counter if on public roadways..need ROW <br />