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e��-�eaoo2o City of Zephyrhill Permit Application Fax 813-780-0021 <br /> y BviSding epartment <br /> • Date Received phone Contact for ermittln � - V {�(_„J <br /> OW118r�Neme � J� � Ownor Phone Number ' �)c�—�7 /� <br /> Owners Address�����(��;(�t.._.,�1C,_ Owner Phane{Vumber �� <br /> Fee Simple TiUeholder Name Owner Phone Number �� <br /> F09 SII�pl6 71tloNOltler Addreas <br /> JQBADDRESS � '� LOT# � <br /> SUBDIVISlON 1 � Il S!11 P�� � 1'C.S� PARCEL t ' Ut�� �' U�t1't3 C.7 <br /> (OBTAINEO FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e New cON57R 8 ADD/ALT [� SIGN C] Q DEMOLISH <br /> INSTAIl. REPAIR <br /> PROPOSEO USE Q SFft Q COMM [,� OTHER <br /> TYPE OF CQNSTRUC710N Q BLOCK Q FRAME � S7EEL Q <br /> DESCRIPTION OF WORK l.J [i�` f , �'"` <br /> SUttDlNG SIZ� � � SQ FOOTAC,E HES�iHT <br /> QBUILDING �� VALUATIpN OF OTAL CONSTRUCTIpN <br /> �ELECTRICAL $ (^�]1 � AMP SERVICE [� PROGRESS ENERGY Q W.R.E.C. <br /> `,,,JIJ <br /> QPl.UMBING �� <br /> �MECHANlCAL $ i"`� VAiUATlON OF ECNANiGA�INSTALLATIOIV I� 1 '" � �� <br /> r t <br /> QGAS Q ROOFING Q SPECIAL [� OTHER <br /> F1NtSHED F�OQR E�EVAT70NS C�� FCOOD Zd E AREA DYES N4 <br /> BUIL.DER COMP NY �� <br /> SIGNATURE REGIST EO Y/ N FEE CURREA Y/N <br /> Address License# ( � <br /> SIGNATUREN 1,� MP Y 1Ll�J�(�t�/1���CtA l��( � <br /> RB6ISTE ED Y N FE6 CURREh Y J N <br /> Address �LJ Y License# �,� �� <br /> PLUMBER COMP NY � � <br /> SIGNATURE REGISTE ED Y/ N FEE CURREA Y/N <br /> Address ticense# � � <br /> ....... <br /> MECHANICAL ��_���,�/��� COMP NY �!0'rr� /JQ��.I-c-���,c I � <br /> SlGNATURE f� �/r REGISTE E6 Y 1 N FEE CURREfi Y I N <br /> -a <br /> Address License# �/'i� �0 � 7J�/ � <br /> OTHER � � CQMP NY � <br /> SIGNATURE REGISTE ED Y/ N FEE CURREI. Y/N <br /> Address �icense# �� � <br /> I1111111111111111111111111111111111 IIII111111111111111111111111111 <br /> RESIDENTIAL Attech(2)Plot Plans;(2)sets of Building PlanS;{tj set of E ergy Fonns;R-O-W Permitfor new consWCtion, <br /> Minimum ten{10}woriting days after submlttai date. Requi d onsite,ConstruGion Pians,Stormwater Plans wl Silt Fence inslatied, <br /> Sanitary Facilikies&1 dumpster.Site Work Permit for subdi 'sionsllarge projects ' <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a L'rfe Safery Page;(1)set of Energy Fartns.R-O-W Permit for new conswction. <br /> Minimum ten(10)working days aRer s�hmi8ai date. Requi d ansite,ConsGVCtion Pians,Stormkvater Pla�s wt Siit Fence instalied, <br /> Sanitary Facilities&t dumpstar.Sife Work Pertnit for alt ne projeats.AfI commercial requirements must meet cornptiance <br /> SIGN PERMI7 Attach(2)sets of Engineered Plans, <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out applica0on compietely. <br /> Ovmer&ConVactor sign back of application,notarized <br /> I(over§2500,a Natica o(Commenasment is required. {AtC npgrades ver 57640} <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be so eone with notarized letter from owner authorizing sama <br /> OVER THE COUNTER P�RMI171NG (Front of Application Only) <br /> Reroofs sf shiagtes Sewers Serv3ce llpgrades AJG �ences{Pto uroeytFootage} <br /> Driveways-Not over Counter if on public roadways.,needs RQW <br />