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813-780-0020 City of Zephyrhill� Permit Application Fax-813-780-0021 <br /> Building epartment <br /> Date Received+ a Phone Contact for ermitting 1 - O`I <br /> .� <br /> Owner's Name � 1 � Owner Phone Number <br /> Owner's Address 5335 '� • �`� ✓� `'� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple 7itleholder Address <br /> JOB ADDRESS I WI I 1 � (/�• ` `�� U LOT# � <br /> SUBDIVISION PARCEL 1 # ~'���Z�� �VI O IJt�V rVV�V <br /> (OBTAINED FROM PROPERTY TAX NOTICE) � <br /> iNORK PROPOSED B NEW CONSTR B ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR � �� <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTIOM Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK � �JI--' J I I� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ ��(1 VALUATION O TOTAL CONSTRUCTION <br /> V <br /> QECECTRICAL $ AMP SERVIC Q PROGRESS ENERGY Q W.R.E:C. <br /> / <br /> QPLUMBING $ ��� <br /> QMECHANICAL $ VALUATION O MECHANICAL INSTALLATION (i��'S <br /> QGAS � ROOFING Q SPECIAL 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA �YES NO <br />-- BUILDER - -----—�COM ANY-- - -�- - --- <br /> -- — --— ---- ---- -- — <br /> SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COM ANY <br /> SIGNATURE REGI RED 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 COMPANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER CO PANY YY�W� � O I�G <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> I Address �`-t 1� ��2 I License# C ��j2� J <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set o Energy Fortns;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 instatled, <br />> _ Sanitary F�cilities_8 1 dumpster,Site Work Permit for su divisionsAarge projects- - --_-- --------- <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Sa ety Page;(1)set of Energy Forms.R-O-W Pertnit for new construction. - <br /> Minimum ten(10)working days after submittal date. Re wred onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <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 construc on. <br /> Directions: <br /> Fill out application completely. <br />� Owner&Contractor sign back of application,notarized <br /> If over 5Z500,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 sameone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI7TING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences( lot/Survey/Footage) <br />� Driveways-Not over Counter if on public roadways..needs ROW <br />� _ <br />