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813-780-0020 City of Zephyrhill� Permit Application FaX-a�3-�ao-oo2� <br /> Building i epartment <br /> Date Received � Phone Contact for permitting -- � <br /> Owner's Name I <br /> C!'1�C �F z-1����.5 I OwnerPhoneNumber <br /> Owner's Address � g ✓� �Q L,�aov v� vi` �i%�I Owmer Phone Number <br /> Fee Simple Titleholder Name Owrner Phone Number <br /> I <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � � 1 LOT# <br /> � <br /> SUBDIVISION _ PARCEL ID# _ - - --- -- - --------- <br /> ~ (OBTAINED FROAA PROPERTY TAX NOTICE) <br /> IIVORK PROPOSED e NEW CONSTR e ADD/ALT � 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIF� <br /> PROPOSED USE Q SFR Q 'COMM � OTHER <br /> TYPE OF CONSTRUCTIOM Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK <br /> , <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION O�T07AL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �� <br /> �IECHANICAL $ �� �� VALUATION OF MECHANICAL INSTALLATION , ``J� <br /> � <br /> QGAS Q ROOFING Q SPECIAL I Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGIS�'ERED Y/ N FEE CURRE� Y/N <br /> i <br /> Address I License# <br /> I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y J N FEE CURRE� Y/N <br /> I <br /> Address I License# <br /> I <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> i <br /> Address I License# <br /> MECHANICAL COM�ANY �����/!y0 qer.f � S � f� � <br /> SIGNATURE REGISTERED � Y/ N FEE CURRE� Y/N <br /> Address I License# C����� � <br /> I <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> i <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding 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 Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facflities&1.dumpster;Site Work Permitfor subidivislons/large projects <br /> COIVIMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(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 Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permlt for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. � - <br /> '"""PROPERTY SURVEY required for all NEW constructibn. <br /> Directlons: <br /> Fitl out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> �• If over a2500,a Notfce of Commencement Is requlred. (AIC upgra es over�7500) <br /> Agent(for the conVactor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> -,.�...�,....,..-.•�:.. .... ._..: . � <br /> OVER THE COUNTER PERMITTING�� -;tFront'ofAppUcation Only) '-""== ` „.,°�,",°'.°°°-�.°°^�°.�-��-°�.,..�:...� <br /> Reroofs if shingles �ewers , .� ,Service Upgrades AIC.�•; �' Fences(Plot/Survey/Footage)z �• ; - - � . ' . ` <br /> :�i ' - ` -, • i . . _" , , ' , • i <br /> Driveways-Not over'Counter if�on�public roadways..needs�ROW ` , '` '- '," '' �- ' •� ` <br /> ,,....�� „-_-F.,->_ ...,...-.. :�_, . •,..: ._ :. . .:. .-... ... ....... ....�... __:... �.-: . �..-,� <br /> � <br /> I <br />