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813-780-0020 City of Zephyrhill Permit Application Fax-813-780-0021 <br /> Buildir�g Uepartment <br /> s <br /> Date Received phone Contact for Permitting __ <br /> -Owner's fVame � ,� Owner Phone Number 7 — ! <br /> Ouvner's Address � f M C, � W� - Owner Phone Number <br />, Fee Simple Titleholder Name Owner Phone Number <br /> , F�e Simple Titleholder Address <br /> JOB ADDRESS GLM � ([. C( LOT# �� <br /> SUBDIVISION PARCEL I # <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED " B NEW CoNSTR ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL ' REPAIR <br /> PROPOSED USE Q SFR COMM 0 OTHER <br /> TYPE OF CONSTRUCTIOM Q BL06K Q FRAAAE � STEEL Q - <br /> IDESCRIPTION OF WORK F� � (/ ' ��/ /�/1 / '/ni1 % � ' <br /> BUILDING SIZE SQ FOOTAGE HEIGH <br /> QBUILDING $ VALUATION O TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> �IECHANICAL $ VALUATION O MECHANICAL INSTALLATION I�� � � <br /> QGAS Q ROOFING Q SPECIALT 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO <br /> BUILDER COflIIP NY <br /> SIGNATURE REGIST RED Y/ N FEE CURRE� Y/N <br /> Address � License# <br /> ELECTRICIAN COMP NY � - --'- -- - - - - <br /> SIGNATURE REGIS RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMP NY <br /> SIGNATURE REGIST RED Y/ N FEE CURREA Y/N . <br /> Address � License# <br /> MECHANICAL -- COMP NY OV � ii�/1 Ii S �i T�� � <br /> SIGNATURE REGIST RED Y/ N FEE CURRE� Y <br /> Address License# <br /> OTHER COMP NY <br /> SIGN�►TURE REGIS RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buflding Plans;(1)set of nergy Forms;R-O-W Permit for new construc6on, <br /> Minimum ten(10)working days after submittal date. Requi ed onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities&1 dumpster;Site Work Permit for subd visionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safe Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Requi ed onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster.Site Work Permit for all n w projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach{2)sets of Engineered Plans. <br /> "`"PROPERTY SURVEY required for all NEW constructio . ' - <br /> Dlrectlons: � <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over;2500,a Notice of Commencement(s required. (A/C upgrade over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be s meone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING J ,s�i�(Front-of Applicatio�n;Qnl�) <br /> Reroofs if shingles Sewers �'��•Service Upgrades ALC.;_.�_> ,:Fences(PI t/Survey/Footage) <br /> `� _ ._ �:.. . - <br /> Driveways-Not over Counfer if on public roadways::needs�ROW� <br />