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813-780-0020 City of Zephyrhill Permit Application Fax-813-780-0021 <br /> 8uilding epafinent <br /> Date Received <br />' Phone Contact for ermitting - <br /> Owner's Name ��(3AS a0 1� iN 1�,� L� Owner Phone Number <br /> Owner's Address 4 a ( � .SO �" '���� � 33 � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address � <br /> � i � n �qC an u <br /> JOB ADDRESS C�a� � Q LJ �0� n�. �nfiYi v�nq� qQ g �d/� � LOT# <br /> �� <br /> - -SUBDIVISION -- --- - - ------- - —PAPtCEL-I # - - - - - - - - - - - - _ <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADDlALT � SIGN Q Q DEMOLISH <br /> INSTALL� REPAIR <br /> PROPOSED USE Q S�R Q COMNI � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ � � VALUATION F TOTAL CONSTRUCTION <br /> �ELECTRICAL $ ���� AMP SERVIC Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION F MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECI � OTHER <br /> FINISFIED 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 y7 ,( /� CO PANY � d ��nP� <br /> SIGNATURE ��J� S o `��N�'N��t1�L,TI REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER CO PANY <br /> SIGNATURE REG STERED Y/ N FEE CURRE� Y/N <br />, Address Lfcense# <br /> MECHANICAL CO PANY <br /> SIGNATURE REG STERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER CO PANY <br /> SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> Address 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 quired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities&1 dumpster;Site Work Permit for s bdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building 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 Facilitles&1 dumpster.Site Work Permit for I new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""'PROPERTY SURVEY required for all NEW constru tion. <br /> Directions: <br /> Fili out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> IF over 52500,a Notice of Commencement Is required. (A/C upg ades over 5T500) <br /> "' Agent(for the contractor)or Power of Attomey(for the owner)would e someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIITING (Front of Appli,cation Only) <br /> Reroofs if shingles Sewers Seryice Upgrades_�A/C ' �Fence (PIoUSurvey/Footage) - • . • ._ : � <br /> � ' ` - , ' "` • 't < _ _ � . - <br /> Driveways-Not over Counter if on public roadways..needs ROW , ' _ ,, „ � . , , <br />