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813-780-0020 City of Zephyrhill Permit Application Fax-813-780-0021 <br /> � Building epartment <br /> Date Received Phone Contact for ermttting -- <br /> tn <br /> Owner's IVame 6 Owner Phone Idumber ' S "' .� <br /> Owner's Address G 6 3 � 6c ( Owmer Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS [ C5 G��'t !\ � f LOT# � <br /> SUBDIVISION PARCEL D# <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 Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK C � v� �� (Zi y.t �f ��-� �� � <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ VALUATION F TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVIC Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> ' MECHANICAL $ � ��� VALUATION F MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIA 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 <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address �7�d �s�e,c S� Cr J c+ License# <br /> OTHER � CO PANY <br /> SIGNATURE � REG STERED Y/ N FEE CURRE� Y/N <br /> Add�ess License# � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set f Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. R uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster;Site Work Permit for s bdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Buildfng Plans plus a Life S fety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. R quired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for al new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. -J�- �— � <br /> ""'PROPERTY SURVEY required for all NEW consVu tion. - <br /> Directions: . <br /> Fill out appiication completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement Is required. (A/C upgr des over 57500) <br /> •• Agent(for the contrabtor)or Power of Attomey(for the owner),would b someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING, ` ','. (Front of Application Only) - _' � <br /> Reroofs if shingles Sewe�s Service Upgrades�A/C ,Fences(PIoUSurvey/Footage) , ^ , <br /> . , <br /> Driveways-Not over Counter if on public roadways..needs ROW • � " _� . <br />