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813-780-0020 City of Zephyrhill Permit Appiication Fax-813-780-0021 <br /> . , s Buildin Department <br /> Date Received � � � �y phone Contact fo Permitting ��-� �2- -- -��T � <br /> Owner's Mame ���15 ro �OfJS/�� ,��i�� Owner Phone Number <br /> Owner's Address � � 9�d ����'��/ �� Owner Phone Number <br /> Fee Simple Tltleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 7�0�� G(/�S/���/�' ,/' LOT# � <br /> SUBDIVISION PARCEL D# `��Ga— 2 J— �/6 4— oc�o o-- C�v <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FFtAME 0 STEEL Q <br /> DESCRIPTION OF WORK /����� c>t.�'� /i' ACi/ � %OIr/ /� ��'�� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT - <br /> QBUILDING $ VALUATION F TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVIC � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � <br /> MECHANICAL $ �--700� �� VALUATION F MECHANICAL INSTALLATION . �a� <br /> / '�C �, <br /> QGAS Q ROOFING Q SPECIAL 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ONE AREA QYES NO <br /> BUILDER CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER CO PANY %/�iI v�0.� S lf C � ���5 i/;C� <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# � C%�/ 7 3� <br /> MECHAMICAL CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> �Address ���y���JI���Lk��%�C l-� �( 3���x' License# <br /> OTHER CO PANY <br /> SIGfdATURE - REGI TERED Y I N FEE CURRE� Y/N � <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set o Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days.after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facflities 81 dumpster;Site Work Permit for su divistons/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Sa ety Page;(1)set of Energy Forms.R-O-W Permit for.new construction. <br /> Minimum ten(10)working days after submittal date. Re uired 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 construc on. <br /> Directions: , <br /> Fill out appiication completely. <br /> Ovmer&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgra es over 57500) <br /> "• Agent(for the contractor)or Power of Attomey(for the owner)would b someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI7TING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences( IoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />