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613-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021 � <br /> Building Department <br /> Date Raceived z—I�I 3 Phone Coatact for Pertnittin 'l� —D�� � <br /> Owners Name C O� s Owner Phone Number -3g?'Q(Q p <br /> Owner's Address ��� L�N w �C. Owner Phone Number � <br /> Fee Simpla Titleholder Name � Owner Phone Number <br /> Fee Simple Titleholder Address /V,� <br /> JOB ADDRESS ��� L•�NG OIId�1IC. 4���s ��17 •� LOT# [� <br /> SUBDIViS10N 1+�I�GO�N �L� '� PARCEL ID# �����0� ��D�U O �[/���Q DG70 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED �] NEW CONSTR B ADD/ALT Q SIGN Q Q DEMOLISH <br /> [1�JJ INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER J • w� • , <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME Q STEEL Q <br /> DESCRIP710N OF WORK i St� J�/tOd f�oor���Sf�� �"������ <br /> pM <br /> BUILDINGSIZE IZ�X Z7,�' •• SQFOOTAGE 3 O HEIGHT ,M�►1C 4X•S ��n� <br /> �.vt'.o <br /> �B�ILDING $/�/y� � p O VALUATION OF TOTAL CONSTRUCTION <br /> (D � <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> Q PLUMBING $ � A�/'� <br /> �v�, <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALlATION � �y ^1 J _C�� <br /> � ��r �� [� <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER � �'�7�� <br /> _� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER N� Q � COMPANY }''�V�n•.v�M l_,O/JGG p'tS � [' `, <br /> SIGNATURE REGISTERED Y/ N FEE CURREh /N <br /> Address 3?3 3 L-a.�.t�t'�r �•� �) J License# a�Z � <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE N REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> PLUMBER / COMPANY � <br /> SIGNATURE ��� REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> MECHANICAL � � COMPANY � <br /> SIGNATURE REGISTERED Y! N FEE CURREfv Y/N <br /> Address License# �� <br /> OTHER � COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURREh Y!N <br /> Address License# <br /> Illllllllllllllllllllllllllllllllllllllllllllllllllttittlllllllllll <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 aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Lrfe Safety Page;(1)set of Energy Forms.R-O-W Permit for new construdion. <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 reqwred for all NEW construction. <br /> Directions: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized <br /> If over S2500,a Notice of Commencement is required. (A/C upgrades over 57500) <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 rf shingles Sewers Service Upgredes A/C Fences(PIoUSurveylFootage) <br /> Driveways-Not over Counter'rf on public roadways..needs ROW <br />