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<br />813-780-0020 <br /> <br />City of Zephyrhill Permit Application <br />Build II , Jepartment <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br />q -;;)'l.o-O (P <br /> <br />~'l" H, 'J', < <br />5~c..-k l~/ <br /> <br /> <br />Owner's Name '"" ().. '" <br /> <br />Owner's Address I J' Lf I J <br />Fee Simple Titleholder Name I <br /> <br />~~ <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />! 3~ &0 2.. ~(?,f" "<j <br />~^(h I <br />1><1 NEW CONSTR E3 ADD/ALT 0 <br />INSTALL REPAIR <br />PROPOSED USE [lSJ SFR D COMM D <br />TYPE OF CONSTRUCTION [R] BLOCK D FRAME D <br />DOSCRlP110N OF WORK Is:, ') I( Fe ~ : l'f r 1.1 ~ ~r, ..... c, <br />BUILDING SIZE L J SQ FOOTAGE _ , to ~' 2.. <br /> <br />JOB ADDRESS <br /> <br />LOT' <br /> <br />I j 'f <br /> <br />~Ju.f I <br /> <br />PARCEL 1011 14. - 2(0 ,,1 \ - 0 II D ,- OOO()O - 6) 1'-1 0 <br />(OBTAINED FROM PROPERTY TAX NOnCE) <br />SIGN D MOVE D <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />HEIGHT 1_ <br /> <br />- <br />[lJ BUILDING 1$ <br /> , ') 0, tJv() <br />[SZ] ELECTRICAL 1$ <br />GJ PLUMBING 1$ <br />0 MECHANICAL 1$ <br />D GAS (2:1 ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> ~- <br /> <br />AMP SERVICE ')..Do <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />C29 <br /> <br />WRE,C. <br /> <br />PROGRESS ENERGY c:J <br />~../ <br />RoW'; <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />D SPECIALTY D OTHER <br /> <br />I FLOOD ZONE AREA DYES DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />! 1l4I ~ <br />I/#/~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address <br /> <br /> <br />~=~RE ! 1M! ~ <br />1JdJ~ <br /> <br />, <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE : <br /> <br />Address <br /> <br />~I~~~~URE I. 4lJ) ~ <br /> <br /> <br />Address . <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />f-v "'" 4. '" <br />I Y/ N I <br /> <br />61\5'+ <br />FEE CURRENT <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />~ Cd+- <br />I Y/ N I <br /> <br />License' I <br /> <br />PeeS(. a <br />FEE CURRENT <br /> <br />E /.f( <br />I Y/N <br /> <br />License , <br /> <br />Lf.en~'. \ <br />Y/N I <br /> <br />w,' \\; Q..., s <br />FEE CURRENT I Y / N <br /> <br />License' <br /> <br />So u.\-ltc ~ (:0"" fort- <br />I Y / N FEE CURRENT I Y / N <br />License .. I <br /> <br />(l ~,.... Ct " <br />I / N I <br /> <br />f0" .f".,~ <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License , <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns <br />Minimum ten (10) working days after submittal date, Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Fonns, <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans, <br />****PROPERTY SURVEY required for all NEW construction, <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />-- .. <br /> <br />Directions: <br />Fill out application completely, <br />Owner & Contractor sign back of application. notarized <br />If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) <br /> <br />Agenl (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />Driveways-Not over Counter if on public roaclways..needs ROW <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />f\~~ <br /> <br />0/\ <br /> <br />h' \-Q <br />