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813-78Q-0020 City of Zephyrhill Permit Application Fax-813-780-0021
<br /> Building epartment
<br /> Date Receided -��-t[..� Phone Contact for ermitting �. �( -- ��
<br /> Owner's Name ��C,hC�vr� �' � g��,� �/� Owner Phone Mumber �C�'° ��J 1-' (��oo�
<br /> Owner's Address ���p�� �- L2,�2. ��- � Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB R�DRESS J��C� -'( , �Le (� � 5 LOT# �
<br /> SUBDIVISION PARCELI # �U'��-�.�I- �Io'�f%�-�Q��a"' Q�o3f3 ---_ --- _,^-
<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 Q OTHER
<br /> TYPE OF CONSTRUCTION Q _ BLOCK Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK 1�Y i"il.. �.,�,�-' � V a'��-�
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br /> QBUILDING $ VALUATION O TOTAL CONSTRUCTION �
<br /> QELECTRICAL $ AMP SERVIC Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $
<br /> �ECHANICAL $ �; VALUATION O MECHANICAL INSTALLATION
<br /> �t1�� . �
<br /> QGAS Q ROOFING Q SPECIAL 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO
<br /> BUILDER - - -COi'�i �►NY - - - -- _ __
<br /> SIGNATURE REGIS RED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAN COM ANY
<br /> SIGNATURE REGI ERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> PLUMBER COM ANY
<br /> SIGNATURE REGI ERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> MECHANICAL I��,y�_�y� CO PANY �YW�"S � �
<br /> SIGNATURE `��F��� REGI TERED N FEE CURRE ! N
<br /> Address I �a�� U (� �G� License# 1... � �� ���
<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 o 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 Facflities&1 dumpster;Site Work Permit for su divisionsAarge projects
<br /> COMMERCIAL Attach�3)complete sets of Building Pians 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 8�1 dumpster.Site Work Permit 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 construc on.
<br /> Directtons: �
<br /> Fill out appiication completely.
<br /> Owner&Contractor sign back of application,notar(zed
<br /> If over 52500,a Notice of Commencement is,requirgd,.. (AlC upgra es over ST500)
<br /> ,,�,�,.:..,:-.,..�.�:.:._.. ,_,
<br /> *' Agent(for the contr�'ctor)or Powec of:Attomey(for•the,owner)would b someone wlth notarized letter from owner authorizing same
<br /> ;:,'.��- - �._..............:.:._. - . , _, . ...�,�,...� .�
<br /> OVER THE COUNTER PERMITTING• •.....(Front,of;Applicatio��Only) ; �� �" • �
<br /> Reroofs if shingles Sewers.,,`;,;.„,Service Upgrades`A"/C';�` ;Fences( lot/Survey/Footage) ` " � - ';; ;; � ��'� �'
<br /> �.c_�.\r .�-n.�. . --. : . .�...NV_.. ,a5' .-�., i.. A�.'S � � ., � . � • � ' `
<br /> Driveways-Not over Counter if on public roadways..needs ROW ' -, . _ .;. � .�..... -
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<br /> s...�,_. �,... ..� . ... < .,�._..,. - ..,...,.�.._
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