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, 813-780-0020 City of Z�ph rhills Permit Application Fax-813-780-0021 <br />' B ilding Department <br /> � <br /> Date Received 1 ^�Cj ' ��0 3 �S - �I O p <br /> (/ ��s Phone Conta t for Permittin <br /> Owner's Name J��G- CX( S LC ner Phone Number <br /> Owner's Address J I�t'`T d ��-�'e- ILCd • C., ��S n Owner Phone Number <br /> .3��G <br /> Fee Simple Tttleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOBADDRESS �� �S�'S b� S'�`� rIti ��S t� ��5��- LOT# � <br /> SUBDIVISION - PAR EL ID# -�-r 1 - �O 1 O - Z�O� Q'7( <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD ALT � SIGN Q Q DEMOLISH <br /> INSTALL REP IR <br /> PROPOSED USE Q SFR Q CO M 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRA E 0 STEEL Q <br /> DESCRIPTION OF WORK �P.�Q��d- \r�V S�.�r ,,�' � <br /> BUILDINGSIZE � `'(�� S� SQFOOTAGE HEIGHT �L�� <br /> � <br /> �BUILDING $ �v VALUATI N OF TOTAL CONSTRUCTION <br /> � d � <br /> QELECTRICAL $ AMP SE VICE Q PROGRE S ENERGY Q W.R.E.C. <br /> QPLUMBING $ � ����� �f� <br /> fv <br /> �MECHANICAL $ VALUATI N OF MECHANICAL INSTALLATION r <br /> QGAS Q ROOFING Q SPE IALTY 0 OTHER ��/ S� i <br /> FINISHED FLOOR ELEVATIONS FLO D ZONE AREA QYE NO �'�,'�l. <br /> M��c� � <br /> �.. <br /> BUILDER ` J `� � OMPANY � �ivLr�S �1� <br /> SIGNATURE � EGISTERED Y/ N FEE CURRE� Y N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE EGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> 51GNATURE EGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> 51GNATURE EGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> DTHER COMPANY <br /> 51GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br />_ Address - License# <br /> 2ESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1) et of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construct(on Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facillties 8�1 dumpster;Site Work Permit f r subdivisions/large projects <br /> �OMMERCIAL Attach(3)complete sets of Building Plans plus a Lif Safety Page;(1)set of Energy Forms.R-O-W Permit for new consVuction. <br /> Minimum ten(10)working days after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit f r all new projects.All commercial requirements must meet compliance <br /> �IGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW con truction. <br /> )Irections: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement Is required. (A/C u grades over$7500) <br /> ' Agent(for the contractor)or Power of Attomey(for the owner)wou d be someone with notarized letter from owner authorizing same <br /> )VER THE COUNTER PERMITTING - -(Fronf of Application�Only)'. � � - <br /> teroofs if shingles Sewers Service.Upgrades,N,C Fen es•(PIot�Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW -. <br />