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��saso-oozo City of Zephyrhill Permit Application Fax-813-780-0021 - <br /> �:,Y��• Building Department <br /> � 1 <br /> �Received Phone Contact fo Permitting -- ' <br /> s /� c, <br /> Owner's Name ��l�s� /J F�-�r-�G � Owner Phone Number p �.3 "'9 9� 3.�tr� <br /> Owner's Address ���ya ����� � �N �� Owner Phone Number ' <br /> Fee Simple Titleholder Mame �/ ��,y-f.� C��� � Owner Phone Number <br /> Fee Simple Titleholder Address �d�SG'a? �S • �°� <br /> JOB ADDRESS J�r`lOY� �C�aI 1..� B.1 ��: LOT# � <br /> SUBDIVISION c�//a",�(, �S�p�J �1�'1�--,C� PARCEL D# O 2 �2�"' ZI °• O Z�O — D C9��(� '°'C���C! <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CoNSTR ADD/ALT Q SIGN Q Q DEMOLISH <br /> B INSTALL 8 REPAIR <br /> P6tOPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ VALUATION F TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVIC Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ �� <br /> QMECHANICAL $ VALUATION F MECHANICAL INSTALLATION <br /> � `�� <br /> QGAS Q ROOFING Q SPECIA � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ONE AREA QYES NO <br /> BUILDER CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN CO PAMY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER CO PAIdY <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 /> RESID�NTIAL 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 instailed, <br /> Sanitary Facifltfes&1 dumpster;Site Work Permit for su divisions/large projects <br />_____COMMERCIAL- __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. Re uired onsite,Construction Plans,Stonnwate�Plans w/Silt Fence`installeif, — � <br /> Sanitary Facilities&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 constructl n. <br /> Directlons: <br /> Fill ouf appiication completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over�2500,a Notice of Commeneement Is requlred. (A/C upgra es over b7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COURlTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences( lot/Survey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW <br /> � . <br /> , � ' <br />