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� ° s�s-�eaoo2o City of Zephyrhill� Permit Application Fax-813-760-0021 <br /> � Building Department <br /> Date Received Phone Contact for ermittin -- <br /> Ovvner's IVame �, Q Owner Phone IVumber 3 �� � �p�� <br /> Owner's Address �3 S ` Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titieholder Address <br /> JOB ADDRESS LOT# � <br /> SUBDI!/ISION � PARCEL I # �2 Z Z I OD�0 d d l aG D0� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> UUORK PROPOSED e NEW CONSTR B ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTIOM Q BLOCK . FRAME � STEEL Q <br /> DESCRIPTION OF WORK � Q G � � � , V �, <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ /'_� �p VALUATION O TOTAL CONSTRUCTIOIV <br /> (..� <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> OMECHANICAL $ VALUATION O MECHANICAL INSTALLATION �l ���?/ <br /> �GAS Q ROOFING Q SPECIAL 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO f V� <br /> BUILDER COM ANY <br /> SIGNATU REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COM ANY <br /> SIGNATl1RE REGIS ERED Y/ N FEE CURRE� Y I N <br /> Address License# <br /> PLUMBER COM ANY <br /> SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IVIECHAMICAL COM ANY <br /> SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COM ANY <br /> I SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address - License# <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. Req ired onsite,Construction Pians,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facflities 8�1 dumpster;Site Work Permit for sub ivisions/large projects <br /> —COMMERCIAL Attach(3).complete sets of Building Plans plus a Life Saf ty Page;(1)set of Energy Forms.R-O-W Pertnit 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 8�1 dumpster.Site Work Perm(t for all ew projects.All commercial requirements must meet compliance <br /> SIGId 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 52500,a Notice of Commencement is required. (A/C upgra es over�7500) <br /> •" Agent(for the contractor)or Power of Attomey(for the owner)would be omeone 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 />