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a�saso-oozo City of Zephy itls Permit Application Fax-813-�80-0021 <br /> Bui ding Department <br /> . • <br /> Date Received Phone Canta t for.Permitting - <br /> Owne�'s Name �,.�Q t i?t.{� rn t�'1�{��' t,� ��J ��-Owner Phoae Number ��J�`'��o�- 1�1� <br /> F ,� ,'t)s �L 33S�l2 (� � <br /> Owner's Address .�� i� F�-�►� ��l � ���� Z�- �/f �` O�er Phane Number � <br /> Fee Simple Titieholder Name Owner Phone Number i , � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � i,;,t�i'Q {,(,.l °" �1 � �� ,j���C LOT# �t> <br /> SUBDlVlStON � � �,��i� pA EE.iLT# �--�� "'yUD I�}- D�'SD� -' D�DD <br /> (09TAINED FROM PROPERTY TAX NOTICEa <br /> WORK PROPOSED e NEW CONSTR 8 AD AL7 �] SIGN C] [� DEMOLISH <br /> IhtSTALL FtEP iR <br /> PROPOSEDiJSE Q SFR Q CO M � 07HER <br /> 7YPE OF CONSTRUGTION C] BLOCK [� F E . �� STEEL [� <br /> n��DESCRtPT10N OF WQRI{ 1'� °E"' � � � �=�- � <br /> BUILDING SlZE �� � SQ EOQTAGE l�IEIGHT � �v " � <br /> 'c BUILDING $ �7� VALUAT Q!�!QF TOTAL GONSTRUGTlQI�f <br /> � �� � �,,..� <br /> QELEC7RICAL ($S -----�� AMP SE VICE Q PROGRESS ENERGY Q W.R.E.C. <br /> � <br /> QPLUMBING ($ '�_ ,, <br /> �-- l�a� <br /> QMECNANtCAL $ VALUA 0(V OF MECHANICAL INSTALLA710N ,�(1 <br /> QGAS Q ROOFING Q 8P CIRLTY �� OTNER <br /> FtNISHED FLOOR EI.EVATIONS � i. � FL OD ZONE AREA QYES NO <br /> � 'ZLlt`��• ��'7 �r�<.�' <br /> � �, �, } <br /> BUILQER ��� COMPANY f11-�V�'ltc•' V` <br /> SIGNATURE �UP.�R t YGt,UL� REGISTERED Y/ N FEE CURRE� Y/N . <br /> Address Lfcense# � `� <br /> ELECTRICIAfd � � COMPANY <br /> StGNATt1RE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Add�ess lfcenSe# � � <br /> PLUMBER " COMPANY. <br /> S1,t'aNATURE Re��s�Reo Y/ N FEE CURRE� Y/N <br /> Address Llcense# �— ��� <br /> M�CN��l9CAl. _ COMPANY <br /> SIGAIATIlRE REGISTEREp Y 1 N FEE CURRE� Y J N <br /> Address Ltaense# �— ^� � <br /> OTHER ` COMPANY <br /> 31GNATURE tt���s7ER�o Y 1 Rt FEE CURREt+ Y/N <br /> Address Lfcense# �—i � <br /> RESIDENTlAi. Attach{2}p!o#Plans;{2)sefs of BuitdEng Plans;(1 set of Energy Forms;R-O-W Permit for new construction, � <br /> Minimum ten{10).working days after submittal.dat . Requlred onslte,ConstrucQon Plans,Stormwa#er Plans w/Stlt Fence tnstatied, <br /> Sanitary Eacllities 81 dumpster;Stte Work Permft or subdivlsionsAarge proJects <br /> COMMERCIA� Attach(3)camptete sets of Buildtng.Plans plus a fe Safety Page;(1}set of Energy Forms.R-O-W Petmit for new constructlon. <br /> Mlnlmum ten(1Q}wrorking days after subrrsfttaf dat . Requlred onsite,GonstrucUon Plans,Stortnwater Plans wf Siit Fence insta!led, <br /> Sanitary Facflities&1 dumpster.Site Work Permit far all new proJects.All commerclal requirements must meet compqanae <br /> SIGN PERMIT Aftach(2}sets af Engineered Ptans. <br /> '•"*PROPERTY SURVEY requlred for ail NEW co strvction. , <br /> Directtans: <br /> FIR ou#appllcatlon completely. <br /> Ovmer 8 Contractor sign back of app!{cation,notarized <br /> If over�2500,a Notice af Commencement Is requlred. (AIC pgrades over 5T500) <br /> '* Agent(for the contractor)or Power of Aktomey(for#he owner)w uld be someone with nota�ized letter from owner authorizing same <br /> OVER 7HE COUNTER PERMITTING (Front of Applicatlon Oniy <br /> Reroots 3fi shingles Sewers ��. °�:',Setvice Upgrades��A/G..�.�..=Fe ces(P1otJSurveyJFoatage} �- - _= .- � . . --. , _ <br /> . _ , . ... + - ': ' � , • <br /> Driveways-Not over Counter if on,public roadways;.needs ROW ' ' � ' � ° � , " �, <br /> D�C <br /> � � - .:���:-er�.a�l, �.�' `.,_ .'.,. -. 4.' :. �_ � ,,. <br /> , <br /> l J <br /> -�i <br />