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813 -780 -0020 City of Zephyrhilis Hermit Appticatlon rax -o I.7- ruu -uuG I <br /> Building Department Ib 3 3" <br /> Date Received Phone Contact for Permitting p I'D -- ;cx 1 <br /> ittiiliNi h ffittifef {¢ — - <br /> Owner's Name Ag � l!1l\ <br /> ac Lvi 'k WF Ow -114(3 <br /> w ner P o ne Number <br /> Owner's Address <br /> : a Owner Phone Number <br /> —� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address rr �p <br /> JOB ADDRESS ' <br /> ... t/ JOB I, Teo & kC. F I ! t "` S ✓ LOT # <br /> SUBDIVISION D BUJ PARCEL ID# ` .Qt5L1 Z `—LI -02 -OAP <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT n SIGN 1 1 MOVE I I DEMOLISH 611 <br /> INSTALL REPAIR � �.r oorf- <br /> PROPOSED USE I 1 SFR I I COMM I I OTHER 15 \n (5I4i, G&Y t 1 t\f V \ 1 \GIC I <br /> TYPE OF CONSTRUCTION (] BLOCK I I FRAME I I STEEL ( I OTHER I <br /> DESCRIPTION OF WORK �� rvn c.)l.)( S /A n (si QS J X1 5t <br /> BUILDING SIZE SQ FOOTAGE Q HEIGHT <br /> V BUILDING $ 1 � ( r ��� [� <br /> t VALUATION OF TOTAL CONSTRUCTION <br /> I I ELECTRICAL $ ``'1 V AMP SERVICE 1 ( PROGRESS ENERGY ( I W.R.E.C. <br /> ( 1 PLUMBING $ <br /> I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> I I GAS [ ROOFING I I SPECIALTY [ I OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IVES I I NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> • <br /> Address License # I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y / N I FEE CURRENT 1 Y / N I <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED ( Y/ N I FEE CURRENT Y/ N I <br /> Address 1 License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address / License # ,� <br /> OTHER \ i / COMPANY 4 n R OO'C�c : <br /> SIGNATU Li �� .. REGISTERED I Y/ N I FEE CURREf I Y/ N I <br /> Address ) (oy ( n : 411/I S 3 3F / License # CCU- i SSo5 <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> " ** *PROPERTY SURVEY required for all NEW construction. <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. (A /C upgrades over $5000) <br /> `" Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />