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813.780-0020 City of•Zephyrhill$'Permit Application Fax-813-78MO21
<br /> Building:Department
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<br /> •. . '(�. �O'iNner PFioriar
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<br /> 'S�'EEL`
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<br /> '..,. :> DESCfiIpTIONOtNRK,; (
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<br /> MUILDING.SIZE
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<br /> VALUAtION O TOTALoae
<br /> ',CON3TF3l1C'ftOlw '<
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<br /> " SERVICE
<br /> QMECHANICAL $ VALUATION OF MECHANI6AL••INSTAl A7,ION'-
<br /> =GAS Q -'ROOFING.; .,,SPECIAI,TY4: OTHER
<br /> FINISHED--fL1OOR;ELEVATIONS: . i (�L00171yZONE`AREA YES:' re-.
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<br /> .BUILDER CtGtS�EANEYD:r' • L, , _ �: v
<br /> Y4SIGNAtURE ROR • A .
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<br /> Address: ur,ge#,� `~
<br /> ELEtCTRiCIAN. :COMPANY;.
<br /> SIGf�ATURE • : `''?REGISttcR1=D� :~; "� - '?F•'EE•;C RREr��;.;�? �:Y'TNr��s
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<br /> :PLUMBER"
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<br /> Address.:-
<br /> MECHANICAL- .,, `COMPAN1f`
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<br /> Y,1'N~" FEE`CUR %kYa�N"S
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<br /> ;RE �1'ER�D..-,•. :��;rY�/,i>I�} c�°'<e:.;,:`sF,EE'CURRE,- t,_ -
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<br /> S ,Eee Af ii' oNns !2=°`FILL Re- fob ne.tcorSs"cdo „,.r.
<br /> REIDEtd'fiA1:'` `AttEh';/' ; ,�gpt" as {( � Eiisbfildl .P�lisfl) t,. 49 .,. , ,(:
<br /> F:,,••.;a\..�.A?n�`1,-�, .+�1 � •zt�+j'n t.aid':*;i � !.E �i':.�s,if �y�2` e•. i •',-0t,._�y.,.f��...�..,.
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<br /> 1111�nrPhufr►.t'err{1.0) brlcliig eays aftierstiblr♦t�r �irt` ;onslfei;Co�nctio Pllt�rrs','$ iateP-.fAfi v�iltilfEer►cd;fnstallstl;'
<br /> Sanitir fftilities'k-1 inlpst�r.5iC .,Vllotk±Fehiilt f8csi�BiltdPslori3%I .tgtl prcjeets`. .`:
<br /> COMMERCIAL. Attach`.(2)_corirpleteis ts-o�,BuI1dlp§Piahs�pllis sit ifF� f Paige,{1j'!si;Y`of;Energy-•Forms-.,-04W PerrriIt:for;nerdy q#gtructiorl.;.,
<br /> �`Mln(niuiim-ter►ibl tworkin rea "wa erg"tirriJ "r:'will, ed onsite;`Gons t(br4P��i say Storriiin�at�J I i1s�wfy iltt erit;e
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<br /> Sanitary Fsdlliiv&A 1_rfiiiti t r.•Sid.• . o�tr c't nn�t r a7l.rieuvaproJects:Alt commerdel;requi�etn nts;mi!§t Nieet;;compii8nca
<br /> SIGN PERMIT Attach:(2j�ets_ofkEngleer6r);PIt1S; r,: a;:; :. _ .
<br /> PROF�R;T;1r� �tiVEr`requr�ed foc=aid New cvfi:§tivcHon:; �=��z - - -
<br /> Direettons:
<br /> °Fill out appllcation-completely.
<br /> :Owrkbk;Co0*totr, ;--"ck o Nappl radon;notarized.
<br /> If ov+�rsZ500;a:Nofl �of Commen�c ment.ls required: .(A/C,upgfades:over:S'7500)
<br /> '• Agent,(forrtale-contractor),or.;Power..;oftAttotney:(for:the�owrrer).w6uid'li8 somebrte,wrth ndtaritdd;letter-frrsm;bwr�er authoiiitng'same .
<br /> OVERT.E:C.OtiN..tER;PERM1171N.G.;. .foopXof ohtre4mqut ed); .,,t. ...
<br /> Reroofs�tfstiingles (Plot/Survey/Footage)
<br /> Driveways-Not over Counter if on.public roadways..needs ROW
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