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813-780-0020 City of Zephyrhill Permit Application- �— Fax-813-780-0021 <br /> Building epartment <br /> Date Receieed <br /> Phone Contact for ermitting -- <br /> Owner's Idame �OY� • 1l� c � Owner Phone Number <br /> Owner's dlddress J�¢�,a , -� S�• Owner Phone Number -` lOQ'��� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> . <br /> JO�e►DDRESS CJ��g �:e LOT# � <br /> � <br /> SUBDINISION PARCEL I # • <br /> --- ' `- ' ` ' - — - - -- — - - -- (OBTAINED FROM-P-RORERTY.TAIC_NOTICE) ! _ __y � __ <br /> VIIORK PROPOSED � NEW CONSTR B ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q Ci�MfVl y �� OTHER <br /> TYPE OF CONSTRUCTIOPI Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK A C� <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 $ n [l <br /> �J(� � i/ v <br /> �ECHANICAL $L'�� VALUATION F MECHANICAL INSTALLATION "� �� <br /> . <br /> QGAS Q ROOFING Q SPECIAL 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO <br /> BUILDER CO PANY <br /> SIGRfATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUIVIBER CO PANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL CO PANY r-1`�T�. U�GFiS <br /> SIGIdATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address P� •�X l i�0 � �7 � � U`Q License# �AC �� �j�{Q <br /> OTHER CO PANY <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 o Energy Forms;R-0-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&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 Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w/Silt Fence instalied, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGM PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construc lon. � <br /> Directlons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is requ(red. (A/C upgr es over a7500) <br /> '• Agent(for the contractor)or Power of Attomey(for the owmer)would b someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIT7'ING;""`'``•";(Front.:of Applicatiorr Only) <br /> Reroofs if shingles �ewers '` � <br /> _ Se'ryice Upgrades NC. ; Fences( Iot/Survey/Footage) �°- --••_-�- :=�� ._.-.... :.,:.,,...._„ ,;.__„e. <br /> . ..' , - „ ,. ,, ,. ,: ,� . :u .. a _ . <br /> Driveways-Not over Counter_if on public roadways:needs ROW , • ' ' � � .' ' � <br /> ,, . , ; , , <br />