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a�saao-oozo ' �ity of Zephyrhill.s Permit Application Fax 813-?80-0021
<br /> . Building Department ��
<br /> � f r
<br /> Date Received _ . Phone CdMact for Permittin" �` ` �` � �
<br /> Owner's Na e ��-���"'r u-°ad d'' C'�'`�`�a�'"''`�0�'""' Owner Phone Number
<br /> Owner's Address Owner Phone Number � �'
<br /> Fee Slmple Tltleholder.Name- � � Owner Phone Number � ` �
<br /> Fee Simple Tltleholder Address , ,� ����' t�� ��
<br /> JOB ADORESS ��3 i � � � � � ��C Z ��LQT# ��]
<br /> SUBDiVIS10N. �— '' ��` PAI2CEL ID#
<br /> •(OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED ' e - NEW CONSTR 8 "�ADDiALT [� SIG{V� Q Q DEMO�ISH �
<br /> INSTALL �REPAIR
<br /> PFt4POSED USE Q 8FR Q GOMM ` � OTHER _
<br /> TYPE OF CONSTRUCTION 'Q BI.00K`' [] FRAME C,� S7EEL Q
<br /> DESCRIPTION OF WORK� �u rn f�s�f�,,e- �+�sC}oS uR-e 8 S a c�- w`4�t-1�--
<br /> BUILDlNG StZE" � �� SQ POOTAGE�. HEI,GFFT �_���
<br /> $� .�`fa,.o„a .
<br /> QBUIl.DING � $ .VALUATION'OF TOTAI:CONSTRt1C'i'EOtd
<br /> . � .
<br /> QELECTR4CAt� � � AMP SERVICE Q PROGRESS ENERGY �Q W.R.E.C.
<br /> �PLUMBING $ � ,
<br /> CC.,
<br /> QMECHANICAL $ � VALUATION OP MECHAN4CR�-IRISTALLATION
<br /> ' �...„
<br /> QGAS Q •ROQFING Q SP.EGIAI.TY �� � OTHER
<br /> FINISHED FLOQR ELEVATIONS ��� FLOOD ZONE AREA QYES NO
<br /> R-�' . V K�'I�UV2 I'YL�I"�07J1�� �!".^' ,. ,
<br /> BUIIDER C4MPANY
<br /> SIGNATURE �� �� REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Address � License# �` �
<br /> E�ECTRICIA[@. COMPANY
<br /> SIGNATURE REGIS7ERED � Y/ N FEE CURRE� �Y/`N
<br /> Address License#��� �
<br /> PLllMB£R ,, . , COMPANY,
<br /> SIGNAT'URE REGISTERED. , , Y L N FEE CURREK', Y/.N .•
<br /> Address � , _ License# �- �.
<br /> MECIiAP11CAl. " COMPANY .x ,
<br /> �SIGNATURE � ' REGISTERED �„xY/-N . , FEE CURRE�;� . Y/N
<br /> Address � �`°<. � ' ' " License.#,� � .
<br /> OTHER. � �` " - GOMPANY . �
<br /> SIGNATURE• � _., ,- ° • - � � � - • 'REGISTERED � ' Y/ N FEE CURRE� Y/N.. .
<br /> Address ' - � ' . . '- 'L`iaense# � �
<br /> REStD�NT111t:. ,•�Attach{2}Plat_PIanS;�`(2};,se#sfof:Buiiding'.Plans;;'(1):sef of Ener'gyi Forms;Ff-f}=1tUxPerini#for new constri.ictian, �
<br /> , .,.
<br /> Minimum ten;(-10),woricing day.s�after=submiital-date:�?Required:onsite sConstniction Plans;Stortnwater•Plans w!S(it Fenae instailed,
<br /> Sanitary Facilities;&;1 dumpstec,�Site;Work,Permit foc,subdivisions/large:projects��, %` , , '
<br /> COMMERCIAI. Attach{3}complete sets�of`Bullding`Plans pl'us a'I:ife`"Safety Page;{1)set a#Enetgy Fomts.R-Q-W Petm�t for new construction.
<br /> Minimum ten(10)working days after submittal date. Required onsike,Canstructlon Plans,Stormwater Plans w/Silt,Fenae Installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Pertnit for all new-proJ.ects.All�commercial requirements must meet compliance
<br /> - ,_ --8t��d-PEl2[�iT- .. Attach�{2)sets af-Engineered;Plaiis.,,__��:��-:�-< . _ :.- -. , -_ _ . .<-- --. .-- _. _ - _._ --_ ----
<br /> •"•«PROPERTY SURVEY requirecl for all NEW cunstrucUon: .
<br /> 3�rections: _ � � � ,
<br /> Fill out applicatlon completely.
<br /> Owner 8�Gontractor sign back of application,notarized
<br /> t#aver 52500,,a Natics af Cammencement 1�requ�rad. (A!G upgrades aver�7500j
<br /> '* Agent(for the'con4ractor)�o��Power of�Attomey(for the owner)would be sortieone with notarized letter from owner autharizing same
<br /> ` 3VERTHECOUNTERyPERMITTING.., ...._._(Front..o£ApplicaBan._Onty}. .- ` - �
<br /> �eroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Driveways-Not over Caunter if on public roadways::iieeils'ROW
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