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. � � , <br /> f <br /> � a��-�ao-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> , Building Department 1 r� <br /> ' ' SC..h0. -2 Y l {�I'�i ' � <br /> Date Received g� 3 `��a, — Oc��'� <br /> Phone Contact for Permitting <br /> 1 1 � 1 t � t � - �' � 7 � � <br /> Owner's Name �rs"I � f'�iS7-iq C'�`�f C ' Owner Phone Number �� ��7�a""��� 1 <br /> ,1- � � I <br /> Owner's Address ���-�-� �� S v��� � Owne�Phone Number <br /> Fee Simple Titleholder Name � � � Owner Phone Number <br /> I <br /> Fee Slmple Titleholder Address � <br /> JOB ADDRESS �O'C� �� �j�e� LOT# � <br /> SUBDIVISION 1 S o� PARC�EL ID# O a -a-to� a I , 0{d D-- 0 OH� � c�al D <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSfR e ADD/ALT � SIGN � Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER Q��oc� <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME 0 STEEL Q <br /> � ��/\ r� <br /> DESCRIPTION OF WORK '�2 I��(�S �i 1 t I I i���3 'I—� F 1 � 1p�i ��O� ( p <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> I <br /> UILDING $ g �, VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ AMP SER i ICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ � <br /> i ��� <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �(\ <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> � <br /> BUILDER COMPANY t"Q�C( S ►� CD�c50 , �� � <br /> SIGNATURE REGISTERED Y/ N FE CURRE� Y/N <br /> _ i <br /> Address � `t-� U� �T1L.:�- ! License# C.�L ��J g 1 .3 � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y 1 N FEE CURRE� Y/N <br /> i <br /> Address I License# <br /> I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ' License# <br /> i <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIt1111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities 81 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-0-W Pertnit for new constructfon. <br /> Minimum ten(10)working days after submittal date.'Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> I SIGN PERMIT Attach(2)sets of Engineered Plans. � <br /> *"'PROPERTY SURVEY required for all NEW consUuction. <br /> Directions:• ' <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized � <br /> If over$250Q a Notice of Commencement is required. (A/C upgrades over$7500) <br /> '* Agent(for the conVactor)or Power of Attomey(for the owner)would be someone 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(PIoUSurvey/Footage) <br /> Driveways-Not over Counter ff on public roadways..needs ROW i <br /> " <br />