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813-780-0020 City of Zephyrhill Permit Application Fax-813-780-0021 <br /> . <br /> Building epartment <br /> Date Received Phone Contact for ermitting -- <br /> Owner's Name I � c� �e Owner Phone Mumber � � /��� <br /> Owner's Address ��7 � �/ b� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS Gvv�w LOT# � <br /> SUBDIVISION PARCEL 1 # o�y°GI��p °07 I ' O��6 '- � `O�f� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> lNORK PROPOSED e NEW CONSTR e ADD/ALT Q SIGfV Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL 0 <br /> DESCRIPTION OF WORK �l��l� �X/� �/i? � <br /> BUILDING SIZE SQ FOOTAGE - HEIGH <br /> QBUILDING $ VALUATION O TOTAL CONSTRUCTION <br /> QELECTRICAL $� AMP SERVIC 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ / <br /> 5 <br /> �MECHANICAL $ �/� �,.,1 VALUATION O MECHANICAL INSTALLATION -Y'`�j�� <br /> (!v e��r <br /> QGAS Q ROOFING Q SPECIAL Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO <br /> - BUILDER -- - - - - COM ANY - - - - -- - --- -- -- - <br /> SIGNATURE REGIS RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAId ' COM ANY <br /> SIGNATURE REGIS RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COM ANY . <br /> SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> � <br /> MECHANICAL , COM ANY l/L/7_� /� � C' <br /> SIGNATURE REGI ERED Y/ N FEE CURRE� Y/ <br /> Address License# <br /> OTHER - COM ANY <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 of Energy Forms;R-O-W Permit fornew construction, <br /> Minimum ten(10)working days after submittal date. Req ired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fac(Ifties 8 1 dumpster,Site Work Permit for su divisionsAarge projects - <br /> COMMERCIAL Attach(3)complete sets of Buildfng 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.Re uired onsite,Construction-P-lans,-Stormwater P-lans-w/Silt Fence installed, - <br /> Sanitary Facilities 8�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 construction. <br /> Directtons: ,�.,,,,„�,�,_;�s, ro <br /> Fill out application complete `.;"`."":','""�;",.'",:;;;':`°�� i <br /> Owner&Contractor sign ba�k of application,�notanzed: °;�� ='.,�, � <br /> If over 52500,a Notice of�ommencement�is required:',.�(A/C upgra es over 57500) <br /> •' Agent(for the contractor)orj�p�pwer of�Attomey(for the�owne�J�.would be someone with notarized letter from owner authorizing same <br /> ,,,: ;; ...- , , __ . -.._. -�. .� <br /> OVER THE COUNTER PERMITTING (Front of ApplicaGon Only) � �''�-'c - - , � . , <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences( Iot/Survey/Footage)` -� � `"•-' � ; • <br /> Driveways-Not over Counter if on public roadways..needs ROW �.,�1� w o�,_.„;,�'r ' �,,,.,....._- _.�:,, <br />