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e�aaeaoo2o City of Zephyrhill Permit Application Fax-813-780-0021 <br /> Building epartment <br /> � , � � ac��- � ��4 <br /> Date Received Phone Contact for ermitting S -1 �a -- LQ�� • <br /> Owner's Name � 1 l �V Y1 �YVZ Owner Phone Mumber ����� ��-a-�L� <br /> Owner's Address 3 ���� � • �� L'��l t-�- Owner Phone Number <br /> Fee Slmple Titleholder Name Owner Phone Number <br />. Fee Simple Titleholder Address <br /> JOB ADDRESS �.I� !�j') 1 ��� �, ! � LOT,# � <br />_ S_UBDIVISION � PARCEL I # <br /> � - `(087AIWED FPtOh9 PROPERTY TAk NOTICE) -- ------- <br /> WORK PROPOSED B NEW CONSTR� 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 � STEEL Q <br /> DESCRIPTION OF WORK �`n S��-\\ C�C`�� ��`` k �'�2 <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ VALUATION O TOTAL CONSTRUCTION <br /> �t��C�Z.� <br /> QELECTRICAL $ AMP SERVIC Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ /�� <br /> � 1�S <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 /> tv d <br /> BUILDER .� `�j' � COM ANY �� rt(J e I����Z��r�� <br /> SIGNATURE ���� - REGI RED Y/ N FEE CURRE� Y/N <br /> Address 3L--1 �h '� Z Yl L�.. License# <br /> ELECTRICIAN COM ANY <br /> SIGNATURE REGI RED Y I N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COM ANY <br /> SIGNATURE REGI ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COM ANY <br /> 51GNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y I 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 Facilitfes 81 dumpster;Site Work Permit for su divisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Buildfng 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 of 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 overS2500,a Notice of Commencement ts required. (A/C upgra es over 57500) <br /> •" Agent(for the conUactor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) F"�'�° "-"� ""`�°�°�_•.w..� ,-,- _. <br /> Reroofs if shingles Sewers � Service Upgrades A/C Fences( IoUSurvey/Footage) � ' ' •��'4-' �-. , <br /> `! _ .,, �=) �,. - ,,., . � - <br /> � ; _ " ' ' ., i <br /> �:i',..? r ' ,r <br /> Driveways-Not over Counter if on public roadways..needs ROW �' .. ,_ ,�,:. _„ ' - , � • � <br /> , _ , ,. ,.. <br /> ,,..,, ..,,� »..,.....-�..�.�_:•�-.. ,r .... . >.�N <br />