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813-780-0020 City of Zephy hills Permit Applicatian Fax-813-780-0021 <br /> Bui ding Department <br /> Date Received phone Canta for Permitting - <br /> Owner's Name Q�� ��� Owner Phone Number � 7� / ��r��� <br /> Owner's Address ���� t �'�� � Owner Phane Number ,_ _,_ <br /> Fee Simple 7ltleholder Name Owner Phone Numbe� <br /> Fee Simple Titleholder Address <br /> JOB ADpRESS ��"�� � �O�� '� LOT# ��� <br /> SUBDiViStON �—i � P11R EL itl# <br /> {d8TA1NED FROM PROPERTY SAX NOTICE) <br /> WORK PRflPQSED e NEW CONSTR 8 ABD LT �� SIGN Q Q DEMO�ISH <br /> INSTALL REP IR <br /> PROPOSED USE Q SFFt Q COM � 07HER <br /> TYPE OF CONS7RUCTION Q BLQCK Q FRA E � STEEI Q <br /> DESCRIPTION OF WORK lrJ ���Y � � �' <br /> BUILDiNG S12E �— ��6�C�FOdTAGE I NEiGHT � ` � <br /> QBUlLDING $���Q� VALUATI� N OF TOTAL CONSTRUCTION <br /> CJELECTRICA� � � AMP SE tCE [� PROGFtE3S ENERGY Q W.R.E.C. <br /> QPLUMBlNG �� <br /> �MECHANICAL $ VALUATI N OF MECNANICAL INSTALLATION � 1 J ` �� <br /> �]GAS Q ROOFING Q SPE IALTY [� OTHER `�S�� <br /> FINISHED FLOQR ELEVA710NS r�� FLO D ZONE AREA QYES NO <br /> L <br /> BUI�DER � OMPAFl1' �� 'L ���I t''� <br /> SIGNATURE EGISTEREp Y! N FEE CURftEP Y t N <br /> Address �f� Gi �PG�"ca �-� License# � � <br /> Ei.EC7RiCtAN � �� OMPANY <br /> 31GNATURE E�ISTERED Y 1 N FEE GURRER Y/N <br /> Address License# � � <br /> PLUMBER � � 0�111PANY <br /> 51GNATURE � EGISTERED Y! N PEE CURREt� Y!N <br /> Address License# �� � � <br /> MECHRNICAL OMPANY <br /> SIGNATURE EGISTERED Y! N FEE CURREI� Y!N <br /> Address ��,�� �- License# �i � <br /> DTHER � OMPANY <br /> 51GNATURE EGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> tESIDENTIAL Attach(2�Plot Plans;{2)sets of Building Plans;{1) et of Energy Forms;R-4W Permit far nsw conshuction, <br /> Minimum ten(10)working days after submittal date. Requlred ansite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facititias&9 dumpsfer,Site Work Permit f r subdivisiansliarge projects <br /> :QMMERGIAL Attach(3)complete sets of Buifding Plans pius a Life Safety Page;{1)set of Energy Porms.R-O-W Permit for new canstruc#ian. - <br /> Minimum Yen(10j working days after submittal date.� Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 81 dumpster.Site Work Pertrnt far all new projects.Ai►commercial requirements must meet campliance <br /> 31GN PERMIT Attach{2)sets of Ertgineered P}ans. <br /> '""PROPERTY SURVEY required for all NEW con truction. <br /> ?IreCtio»s: <br /> Fill out applicatio�completely. <br /> Qwner&Contractar sign back of application,notarized <br /> tf aver$2500,a Notice of Carnmencament is requirad. (A/C u grades over$�500j <br /> * Agant{for the contractar}or Power of Attamey(far the owner)wau d be someone with notarized letter from owner authorizing same <br /> �VER TWE COUNTER PERMITTING (Front of Application Only} <br /> 2eroofs if shingles Sewers �. Seevlce,Upgr�,ades.rAlC.,,. Fen_es(PIoUSurveylFootage} <br /> Driveways-Not over Counter if,on public roadways..needs ROW � <br />