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—�� <br /> e�saso-oozo � City of Zephyrhill Permit Application Fax-813-780-0021 <br /> ; Building Department <br /> Date Received .� .� �� phone Contact for Permitting -- <br /> Owner's Name ��t u /h • � �-�`(�� � '�,� Owner Phone Numb (� � <br /> Owner's Address .�� S Owner Phone Numb <br /> Fee Simple Titleholder Name Owner Phone Number <br /> _ Fee Simple Titieholder Address <br /> JOB ADDRESS �Nl� LOT# � <br /> SUBDIVISION PARCELI # I � �.Zt�` Z I �— Db� — �I P�d° � � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> . INSTALL REPAIR <br /> PROPOSED USE � � SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK �. �a-Il g xf�'s � A � �r7� r��c.��dN si'l.P� �� <br /> BUILDING SIZE SQ FOOTAGE HEI T <br /> QBUILDING $ �3 � a� VALUATION O TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ���� <br /> QMECHANICAL $ VALUATION O MECHANICAL INSTALLATION � � <br /> QGAS Q ROOFING Q SPECIAL 0- OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO <br /> BUILDER �, ) /_n� F�/1 `�OM ANY J�NL2 W N'e✓L. <br /> SIGNATURE LL/�U � j� REGIS ERED Y/ N FEE CURREP Y/N <br /> Address License# <br /> ELECTRICIAM COM ANY <br /> SIGMATURE � REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER � � COM ANY <br /> SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COM ANY <br /> SIG(dATURE REGIS ERED Y/ N FEE CURRE� Y/M <br /> Address - License# <br /> OTHER COM ANY <br /> SIGNATURE rte�is eReo Y/ N FEE CURRE� Y/N , <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of nergy Forms;R-O-W Permit for new consUuction, <br /> Minimum ten(10)working days after submittal date. Req ired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> ' Sanitary Facflities 81 dumpster;Site Work Permit for sub ivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Bufiding Plans plus a Life Safe Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Req ired onsite,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities&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 constructi n. <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 upgrad s over a7500) <br /> •• Agent(for the contractor)or Power of Attomey(for the owner)would be omeone with notarized letter from owner authorizing same <br /> ::.: :_.,... <br /> OVER THE COUNTER PERMITTING";_; :(Front-of-Application Only) _ ._ <br /> Reroofs if shingles Sewers• `,;;�Service:Upgrades AlG�' Fences(P oUSurvey/Footage) � � � _ - - � _ . , ,, , ' ;` <br /> Driveways-Not over Counterif on public'roadways..needs ROW , , _ � �, ,_ ,, v � <br />