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�i 813-780-0020 City of Zephyrhill� Permit Application Fax-813-780-0021 <br /> du(Idmg Department <br /> Date Received � �� Phone Contact fo�Permitting -- <br /> Owner's Name VI lJ Owner Phone Number - li <br /> � <br /> Owner's Address � Y "�,� . Owner Phone Number <br /> Fee Stmple Titleholder Plame Owner Phone Number � <br /> I <br /> Fee Si�nple Titleholder Address <br /> � <br /> JOB ADDRESS � 0�V� �� P�I�C.. • LOT# � <br /> SUBDIVISIOId PARCEL ID# ` • �� '�I -�O��'I � •VlJ� V <br /> "- (OBTAINED FROIIA PROPERTY TAX NOTICE): <br /> 1NORK PROPOSED B NEW CoNSTR 8 ADD/ALT 0 SI� �� Q DEMOLISH <br /> INSTALL REPAIR �o,� <br /> PROPOSED USE Q SFR [� COMM 0 OTHER <br /> TYPE OF CONSTRUCTIOM Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �'�G,1� �� I2� ��(1 I�S <br /> . , <br /> BUILbI(dG SIZE SQ FOOTAGE I�u HEIGHT <br /> Q BUILDING $ l �,��J Q �/�y'1 VALUATION OF TOTAL CONSTRUCTION <br /> "i c..l� Vl/ <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ���� <br /> � � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> QGAS Q ROOFING [� SPECIALTY � �v <br /> 0 OTHER + <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO l <br /> L — - - <br /> BUILDER COMPAfVY <br /> SIGNATURE _ REGI TERED Y/ N FEE CURREA J " Y/rv y <br /> Address I License# <br /> ELECTRICIAN COMPAfdY <br /> SIGNATURE REGI ITERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMIPAPIY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address I License# <br /> I <br /> MECHANICAL COIY�PANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> i <br /> Address I License# <br /> OTHER CO PANY ' �V <br /> SIGNATURE REGI�TERED / N FEE CURRE� N <br /> Address ��UsA—I�� �� � License# Z <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set o Energy Forms;R-O-W Permit for new constructlon, <br /> Minimum ten(10)working days after submittal date. Rec�uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities 8 1 dumpster;Site Work Permit for su¢divisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Buiid(ng 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. Re9uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&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 applicaUon completely. <br /> Owner&Contractor sign back of application,.natariaed,....,;�,..;�._�.,,y,., <br /> If over�2500,a Notice of Commencement�issrequlred. ,(A/G;upgra es over 57500) <br /> '• Agent(for the contractor)orfPower of Attomey�(fo�tfie owner),would;be someone with notarized letter from owner authorizing same <br /> , .. � <br /> OVER THE COUNTER PERMITTING ' � (Front of Application;Only)` a� <br /> Reroofs if shingles Sewers� l" Service Upgrades"A/C�°°° °Fenc�s(Plot/Survey/Footage) <br /> Drivewrays-Not over Counter if on public roadways..needs ROW <br />