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813-780-0020 City of Zephyrh�lls Permit Application Fax-813-780-0021 <br /> �, Buildi g Department <br /> � <br /> Date Received <br /> Phone Contact i r Permitting __ <br /> Oevner's Mame 6 l C �L Ovvner Phone tdumber ��3' / �'y��Z <br /> Owmer's Address Q � � O�mer Phone IVurnber <br /> GX � <br /> Fee Simple Titleholder Name Owner Phone Mumber <br /> Fee Simple Titleholder Address <br /> JOB d►DDRESS U � ��J L.OT# � <br /> SUBDIVISIOM PARCE ID# <br /> (OBTAINED FROM pROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONS7R ADD/AL Q SIGN [� Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM �] OTHER <br /> T1fPE OF CONSTRUCTIOM Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF UIORK �� <br /> BUILDIIVG SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ Ga�'D� VALUATION F TOTAL CONSTRUCTION <br /> r <br /> [�ELECTRICAL $ AMP SERVIC Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � <br /> � <br /> � <br /> QMECHANICAL $ VALUATION F MECHANICAL INSTALLATION y� 1� <br /> ''6` <br /> QGAS Q ROOFING Q SPECIAL Y Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD NE AREA QYES NO <br /> IBUILDER — COIlAPAtdY <br /> SIGfdATURE � REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COM ANY <br /> SIGIdA'iURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COM AMY <br /> SIGIdATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> fNECHANICAL COM ANY <br /> SIGtdATURE REGIS ERED Y/ N FEE CURRE� . Y/N <br /> Address License# <br /> OTHER COAA ANY <br /> SIGfdATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# <br /> ftESID�NTIAL Attach(2)Plot Plans;(2)sets of Building 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 Facilities 8�1 dumpster;Site Work Permit for subdivisions/large projects <br />� COMAAEFtCIAL Attach(3)complete sets of Building 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 Facilitfes&1 dumpster.Site Work Permit for all ew projects.All commercial requirements must meet compliance <br /> SIGN PERIVIIT Attach(2)sets of Engineered Plans. <br /> """"PROPERTY SURVEY required tor all NEW constructt n. <br /> Directions: <br /> Fill out applfcation completely. ;, <br /> Owner 8 Contractor sign back of application,nota�ized <br /> If over 52500,a Notice of Commencement is required. (AIC upgra es over 57500) <br /> •• Agent(for the contractor)or Power of Attomey(for the owner)would be omeone with notarized letter from owner authorizing same <br /> 011ER THE COUNTER PERIVIITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Serv(ce Upgrades A/C Fences( lot/Survey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways.:needs ROW <br />