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813-780-0020 City of Zephyrhill Permit Application Fax-813-780-0021 <br /> c <br /> Building Department <br /> Dat�Received Phone Contact for Permitting -- <br /> Owner's Name � � � I L, Owner Phone Number �z �j) <br /> Owner's Address b�� (,�� ..Q r � � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �C( � /'���C OT# C� <br /> SUBDIVISION PARCEL I # I��lp�� �(,�(j � — Q <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTIi�/ ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL Q� REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �2 � � Q I('(��L <br /> BUILDIPIG SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ VALUATION O TOTAL CONSTRUCTION <br /> ' ELECTRICAL $ AMP SERVICE �� Q PROGRESS ENERGY Q W.R.E.C. <br /> � <br /> QPLUMBING $ �lJ 4L� (_ <br /> a`�'° <br /> OMECHANICAL $ VALUATION O MECHANICAL INSTALLATION� V �� <br /> �� <br /> QGAS Q ROOFING Q SPECIAL 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO <br /> BUILDER COM NY � C <<- � <br /> SIGNATURE REGIST RED FEE C RE� <br /> Address i � � �d . License# <br /> ELECTRICIAN G���/"vJ COM NY Ct � �I'e� C.� irl �'-e t/��-- �� <br /> SIGNATURE REGIS RED Y/ N FEE CURRE� Y/N <br /> Address � � �� - O License# �� bb <br /> PLUMBER COMP PIY <br /> SIGNATURE REGIST RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMP NY <br /> SIGNATURE REGIST RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMP NY <br /> SIGNATURE REGIST RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> __RESIDENTIAL---Attach{2)P-lot-Plans;(2)sets of Building Plans;(1)set of nergy Forms•,R-0-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Requi ed onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facfiities 8�1 dumpster;Site Work Permit for subd visionsflarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safe Page;(1)set of Energy Forms.R-O-W Permit for new constructfon. <br /> Minimum ten(10)working days after submittal date. Requi ed onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for all n w projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> •"'PROPERTY SURVEY required for all NEW constructio . <br /> D(rections: <br /> Fill out application completely. , <br /> Owner&ConUactor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is requtred. (A/C upgrade over 57500) _ , _ _ . <br /> " Agent(for the contractQr).or:Fower..of Attomey(for the owner)would be s meone with notarized I�tter from owner,authorizing same;�•�_�,, ;; <br /> OVER THE COUNTER PERMITTING,. '` Front_of.,A licat`on'Onl �� �� �� -� " "' - ' � <br /> h , :";( PP.,. 4 Y) � .. . �. ., - <br /> ,�� ;�.;. .,: <br /> Reroofsifshingles Sewers ' ' ,Service„Upgrades>NC==: Fences(PI t/Survey/Footage) �' c; ....... .. ....,•, . .._. ' `�' � <br /> Driveways-Not over Cqunter,if<on<public`roadways:n�eds�ROVV „� M y� r� .,� �"" '^ '" �-x:4 <br /> . a`��� <br /> S <br />