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813-7$U-0020 City of Zephyrhill� P'ermit Applica�ion Fax 813-�8p-0021 <br /> � . Buitding Department <br /> E2a4e�ec�av�d a � p�lymn0 Con4�cg for PermiHNrog- �� –!�� �J � � <br /> Owr��r's�tam� t��1..r � Omuner Pisone F}amber <br /> Owner°s e�ddress ���� lN C.,"t, ��CJS �"�"'• puve�gr P9na»�'Rlunt�er � ��, <br /> fee�impi�Yi�1�ho4�ier�1�me �T � C�wn�r 6�hone Wumber � I <br /> Fee Simpie Titi�holder Address <br /> JO�AtDDl3��� � � tt..a"�� ' LA7# �,,� <br /> , <br /> su�oE�asro� �lC��e� �11��.'-� ��ac��e� � -a �� 1- 0(��.C�' C�.�O(�C� -1��t) <br /> (OBTdltdED Fl2C?l4!PRQPERf'`l7AX kOTiCE} <br /> NV0�81C PROPO�E[1 ,,� NEW CONSTR 8 ADD/ALT �� 5lGt�� O Q DEMQLISH <br /> INSTALL REPAIF? <br /> P��dOPO�E�i:USfi Q SFR [� COMM � OTHER <br /> T'Y�E�F C4'iA35�UC1't�� Q BLOCK ' � FRAME � STEEL Q <br /> QESC{�IP�ION OF tWdf3� i'► 1 � l.�' 1 �Y 1 VC ' . <br /> BUILDIPIG SIZE �fl!F9�1'1RG��__� F��IG}43' ��� <br /> OBUiLDIiVG �� VALtJATIOM`OF TC?1'A�COiVS7R1.lCTiOl�i <br /> QEi.ECTRICAL $ � _ ANiP SERVICE C] PROGRESS ENEkaGY Q W.R.E.G. <br /> �.._..� � <br /> QPLUMBiNG � $ � `�^ �� � � �� <br /> {� t <br /> QltRECHANICA� $ VALUATIO(d O�MECH��CAL IfVSTP�t,.L4'TION <br /> C]G�s [� ROOFlNG .Q sp�ci��nr � or��R <br /> Ft�3i5HED FLOpFt ELEVATtOi�S FLQOD ZONE AREA �YES NO <br /> ._,� , <br /> BUIL��it C�Rfl�'/�PIY <br /> S�G��+���� _ REGISTERED Y/ N FEE CURREP Y_/N <br /> �d�r�ss L9cense# 1 � <br /> �L�'���ICi�iPd� CC3flfJ�'APIY � <br /> �0������ � REGISTERED Y/ N FEE CURREP Y/N <br /> �ddre�S L1C@Ilse# �_. ..-..�—.� <br /> ��u���� ��C ��,r� co���nr -e � ',� I 1(VI �-�'i C�1�1 <br /> �����T��� REGISTERED Y.I.Pi EEE CURREA - N <br /> Addr��.s l � '�(� License# .���i ��"-ti ��}� <br /> �IiECH�OC�t COf�PIaltdY <br /> �l�PdA�B��� � ���sr�u Y./ i� �E cur�. . Y/�N <br /> �ddr�a� . - - License# ��. ��� <br /> OY�i�� � � C06�f�Pf�R9Y ,. <br /> ������V�� � REG1Sl'ERED Y/ N,._: ��cuw�n " Y/N <br /> �d�l�es� , - ltcerise#��� ^ � � <br /> R��4DE�tSt�tt:; •A#tacfi`(2}:Riot-_Fians;.(2}sets.of=�Builifirig'Plans;(1}`sef of E'riergy•Fo'rins;.RA=UiI Peririik for nevu canstruction, <br /> � _4Ufi�fmum.ten,{90)wiatlting;days a�tec:subsnittal�date.='Requireti ansite,Canstpuc�on P1ans;Stairriwrater�Pians uvi Sii#'Fence instatteii, <br /> Sanitarjr Fac(IiUes,&:9,.dumpster=Site Work,Rermit for subdidislansllarge=pr6Jects._. ' <br /> C�MIWE�2Cte� Attach(3)compiete sefs of Bulliiing Pians plus a Life Safetlr Page;(1)se4 of Energy Forms.R-O-VII Permit for neuv construction. <br /> Minimum ten('10}wodcing days after submlttaE dat�. Required ansi#e,fionsteuction Plans,Sformwater P1ans w/Sitt Fence instelled, <br /> Sanitary�acilitles&9 dumpster,Site Work Permlt for a!!new projects:,Ail commercia!tequlrec►ients must meei complianae <br /> SIGPd��RFHiT Attach"(2)`sets of Erigi`neeeed�Plans.� . <br /> ""PROPER7Y SURVEY required for ait PdEtN canstruction., <br /> Dtr�c�ions: <br /> F1}}out applicafton camplefety. <br /> Owner&Canhactor stgn baak of appl[catlon,notariz�d � <br /> 8�oerer$2300,a No�ic�of�Commenc�men8 t�required. (BJC up�rades oveP$Y500j <br /> '* Agent(for 4he cantractor)or Pbvuer of AQtomey(for the awrner)would be someone with notarized letter from owner authorizing same <br /> OVEBt TNE�OURI�ER.P'ERMI'�TING -(Pront of Application Only) . <br /> Reroofs if shingtes Sewers 5ervice Upgrades AiC Fenaes(Plot/Survey/Footage) <br /> :. } , <br /> �rivevu�y�-Not over Counter if.on public roadways,.need§ROW ` '� <br />