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s�aaeaoo2o City of Zephyrhill Permit Application Fax-813-780-0021 <br /> • Building Department <br /> `, , <br /> Date Received • phone Contact fo Permitting -- <br /> �Owner's Name � Ls O�Co ✓� Owner Phone Number R��'�"'�� S rZ 12.�- <br /> �Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address } <br /> � JOB ADDRESS LOT# � <br /> SUBDIVISION PARCEL D# _-� -�b�Z�—�I t�C�—C����U� ' �B � �N�1�t <br /> j-�' (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �-��✓.' ( d�( , � 11.' ( !/' V1 i <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ VALUATION F TOTAL CONSTRUCTION <br /> �--- QELECTRICAL $ /� � ���� ;--AMP SERVIC Q PROGRESS ENERGY Q W.R.E.C. <br /> � <br /> QPLUMBING $ r�- I r�� <br /> ����� �� <br /> QMECHANICAL $ ; VALUATION F.MECHANICAL INSTALLATIOfV � <br /> QGAS Q ROOFING Q SPECIAL 0 OTHER l �� <br /> FINISHED FLOOR ELEVATIONS FLOOD NE AREA YES N � <br /> _ Q O <br /> �BUILDER CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> �{: Address License# <br /> ELECTRICIAN � � CO PANY T� �!M�. O C+✓��//' <br /> SIGNATURE REGI TERED Y I N FEE CURRE� Y/N <br /> ..,�:.... <br /> Address License# <br /> PLUMBER CO PANY <br /> SIGI�IATURE�: REGI T�RED 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 License# <br /> OTHER CO PANY <br /> SIGNATURE REGI TERED Y/ 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 Facllities 8�1 dumpster,Site Work Permit for su divisions/large projects _ - - - - - - - - <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Sa ty 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 8�1 dumpster.Site Work Permit for all ew proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets ot Engineered Plans. _ <br /> •'"'PROPERTY SURVEY required for all NEW construct on. . <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over E2500,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 someone wlth notarized letter from owner authorizing.same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C, Fences( lot/Survey/Footage) - • � _ <br /> , <br /> Driveways-Not over Counter if on public,roadways..need's,ROW � ' '� - _ <br /> � : , � _ . ,,.,, , <br /> . ," � ` .; _ -. - . : '• _ . - ..,, � , :. <br /> , , - <br /> , <br /> � <br />