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a��-�so-aoza City of Zeph rhills Permit Applicatian Fax-813-780-0021 <br /> B ilding Department j g t J <br /> �} 7 <br /> Date Rec�+(ved <br /> Rhone Conta t for Perm9tting ( – �p cS^� <br /> Owner's Name j.,...{�� ��-.� �,e, 2,C Owner Phone Number <br /> Owner's Address� � • Owner Phone Number �i � <br /> Fee Simple Titleholder Name Qwner Phone Number � � � <br /> Fee Simple Titleholder Address <br /> �aB aoaaESS:. � 3 b �" ��3 �' �J � �.QT� �� <br /> SUBdlVtS10N �` � PAR EL Id# 1 <br /> - (097AINED FROM PRQPERTY7AX NOTICE) -' - '---- -- - — <br /> WORK PROPOSED e NEW CONSTR 8 ADD! �T � SIGN C] Q DEMOZlSN <br /> INSTALL REP IR <br /> PROPQSED USE Q SFR Q COM , 0 OTFtER <br /> TYPE OF CONStRUCTION Q BLOCK Q FRA E � STEEL Q <br /> DESCRiPTiON OF WORK �� �� n�-e.. �� h S l <br /> Bl11LDING SIZE �^ � Sfl FOOTAGE HEIGHT � � <br /> OBUILDiNG $ ��,3� VALUATtO OF TOTAL CONSTRUCTtON <br /> �El.ECTF2ICA� �'> � AMP SER tCE Q PROGRESB ENERGY Q IN.R.E.C. <br /> �PLUMBING �$", � � <br /> L � �� <br /> �MECHANlGAI $ VA�UATIO OF MEGHANtGAL INSTAE.tAT10N t � <br /> QGAS Q R�OFi1VG Q SPEC ALTY � OTHER <br /> � ` <br /> FINISHED FLOOR ELEVA710NS L� � FLOO ZONE AREA QYES NO <br /> 8t1tLDER MPANY � <br /> SIGNAT RE ISTERED Y/ N FEE GURRE� Y/N <br /> Address License# � _� <br /> EL.ECTRtCtAF1 C MPANY <br /> SIGNATURE F2 ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � —1 <br /> P�UMBER � C MPANY <br /> SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— � <br /> MECHANIGAL C MPANY <br /> 51GNATURE R� ISTERED Y/ N FE�CURRE� Y/N <br /> ....., ,.... .,,,.....,,._.. <br /> Address License# �� � <br /> 07HER � C MP1WY <br /> 51GNATUFtE ,_, RE ISTERED Y/ N FEE CURRE� Y/N <br /> ,,......._„ <br /> Address �icense# �� � <br /> RESIDENTIAL Attach{2}Ptat P(ans;(2)sets of BuitdPng P1ans;(1)set f Ene�gy Fo�ns;R-Q-W Permif far new c�nstruatia�, I <br /> Minlmum ten(10)working days after submittal date. R qufred onsite,Construction Plans,Starmwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for ubdivistonsAarge projects <br /> �OMMERCIAL Attach{3}complete sets of Suilding P1ans plus a�ife S fe#y Page;{1}set of Energy Forms.R-O-W Permit far new consWction. -� <br /> Minimum ten(10)worki�g days after submittal date. Ft quired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster.Site Work Permit for II new proJects.All commercial requirements must meet complfance � <br /> 31GN FERM17 Attach{2}sets of Engtneered Plans. <br /> ""'PRQPERTY SURVEY required for all NEW conslna tion. <br /> �irectians: <br /> Fill out application completely. , ;� <br /> Owner&Contractor sign back of application,notarized t <br /> tf over 52500,a Notice of Commencement Is required. (AlC upgr des aver$T500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would b someone with notarized letter from owner authorizing same ; l; <br /> 3VER TNE COUNTER PERMITTING (Front of Apptication Only} _ . � ,� �� • �f� ,�. <br /> 2eroofs if shingles Sewers Servlce Upgrades A/C Fences PlotlSurvey/Footage) • . ; <br /> drivaways-Not aver Counter if on pubYsc roadways..needs ROW , ' <br />