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813-780-0020 City of Zephyrhill Permit Application Fax-813-780-0021 <br /> , � Building epartment <br /> Date Received Phone Contact for ermitting _ <br /> Owner's Name �N�QS 4C J� GG' �O(�Pi l Owner Phone Number � i 3 �(�{-3�� <br /> Oevner's Address S�� ! ��� J���� Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number <br />� Fee Simple Titleholder Address <br /> JOB ADDRESS ��� K ��� ��f�e� LOTl� �� <br /> SUBDIVISION PARCEL I�# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR B ADD/ALT 0 SIGN [� Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK � Ci� ��� T � f1 cS"�'('�i� h"�" ��( �. c� [��2pY1 <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> OBUILDING $ VALUATION O TOTAL CONSTRUCTION <br /> QELECTRICAL $ , AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> �� <br /> QPLUMBING $ �� <br /> � <br /> �MECHANICAL $ � ��yD.� VALUATION O MECHANICAL INSTALLATION <br /> �� <br /> OGAS Q ROOFING Q SPECIAL Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO <br /> BUILDER COM ANY <br /> SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COM ANY <br /> SIGNATURE REGIS RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COM ANY <br /> SIGMATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COM ANY " 2C.V► �'� � I-t�'+C�O�,�lo(1 � <br /> SIGNATURE t REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address ��-c i�Fa0.{y s� License# C��$� ! L `� <br /> OTHER COM ANY <br /> SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construcdon, <br /> Minimum ten(10)wo�icing days after submittal date. Req ired onsite,Construction Plans,Stormwater Plans w/Silt Fence instalted, <br /> Sanitary Facilit(es&1 dumpster;Site Work Permit for sub ivisionsAarge projects <br /> COAAMERCIAL Attach(3)complete sets of Build(ng Plans plus a Life Saf�ty 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 8�1 dumpster.Site Work Permit for all ew projects.All commercial requirements must meet compliance <br /> SIGM PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY requ(red for all NEW constructi n. <br /> Directtons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> : � If over a2500,a Notice of Commencement Is required. (AIC upgra es over ST500) <br /> '" ' 'Agent(�or the cohtractor)or Power of Attomey(for the owner)would be omeone with notarized letter from owner authorizing same <br /> ,OVER THE COUNTER PERMITTING . . (Front of Application Only) <br /> 'Reroofs if shingles�` Sewers Se'roice Upgrades A/C Fences( lot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />