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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 ermittin -- I <br /> � � � 1 _ <br /> Owner's Name � _ Owner Phone Number � <br /> Owner's Address Ovmer Phone IVumber �Y � �y � � '� <br /> Fee Simple Titleholder Name - Owner Phone Number <br /> .' • <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 2 ,I�S' L �✓ LOT# �� / � <br /> SUBDIVISION _ PARCEL I # _ -- - - -- --- -- -------- -- - �— - __ -�- <br /> � ~ ^ (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTIOM Q BLOCK Q FRAME 0 STEEL Q <br /> . <br /> DESCRIPTION OF W K <br /> > �C i <br /> BUILDING SIZE � � SQ FOOTAGE � � ` HEIGHT i S �2 <br /> �BUILDING $ � VALUATION O TOTAL CONSTRUCTIOfV <br /> QELECTRICAL $ AMP�SERVIC 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> � <br /> QMECHANICAL $ VALUATION F MECHANIGAL INSTALLATION j � � ��� <br /> QGAS Q ROOFING Q SPECIAL Q OTHER �� � <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO <br /> , <br /> BUILDER COMPANY <br /> SIGNATURE REGI TERED Y! N FEE CURRE� /N <br /> Address License# � <br /> ELECTRICIAN CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Pians,Stormwater Pians w/Silt Fence instalied, <br /> Sanitary Facilit(es 81 dumpster;Site Work Permit for s divisions/large proJects <br /> COAAMERCIAL Attach(3)complete sets of Building Plans plus a Life Sa ety 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&1 dumpster.Site Work Permit for al new projects.All commercial requfrements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Enginee�ed Plans. <br /> "7'PROPERTY SURVEY required for all NEW construc on. - <br /> Directions: . <br /> Fill out application completely. <br /> Owner&Contractor sign back of appHcation,notarized <br /> If over�2500,a Notice of Commencement is required. (AIC upgr des over 5T500) <br /> •• Agent(for the contractor)or Power of Attomey(for the owner)would b someone with notarized letter from owner autfiorizing same <br /> OVER THE COUNTER PERMITTING = � (Front of Application Only.) - ,- � - <br /> Reroofs ff shingles Sewers Serv,ice;Upgrades A/C ; Fences Plot/Survey/Footage) ` .- ' - ° ��' ' _ . <br /> Driveways-Not over Counter if on public roadways..needs ROW � " � " _' � ' � = ; � <br />