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8»-78aoo2o City of Zephyrhills Permit Application Fax z� <br /> ' sui�m�oeparane�c <br /> Date Received � � phone Contad for P itting !Z-1 �«' - �d�� <br /> Owners Name (� �,L.l N p C.�b� �I 'S <br /> Owners Address J (� � I Owner Phone Number <br /> Fee Simpie Titleholder Name I Owner Phone Number <br /> I <br /> Fee Simple,Titieholder Address I - <br /> JOB ADDRESS � 3 S� I LOT# � <br /> SUBDIVISION PaR IEL IDtf 1� -Z 6— 2� � 00 i C7- ��2.ba0_ OO L O c7 <br /> (OBTAINED FROM PROPERTY TAX NOTICE� <br /> WORK PROPOSED NEW CONS7R ADD/ALT � SIGN � � DEMOLISH <br /> INSTALL B REPAIIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONS7RUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTON OF WORK 1��+�'L.i,C` ��)�J,WOl/�� S I2���� S 1 � <br /> BUILDING SIZE SQ FOOTAC3E� HEIGHT � <br /> BUILDWG $ �OO VALUATIiN OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. , <br /> QPLUMBING $ i�`�� <br /> � ��^ ��� � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION��i <br /> QGAS Q ROOFING Q SPEiIALN Q OTHER � �V� <br /> FINISHED FLOOR ELEVATIONS FLOiD ZONE AREA QYES NO <br />, /� r-, ��,,/ �N,�� <br /> BUILDER IOMPANY R� 1�' w 1� D�+\ � ��`�' <br /> SIONATURE t REGISTERED Y/ N FEE CURREN Y/N <br /> Address � 'Ttal I��- License# <br /> I <br /> ELEC7RICIAN , COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> I <br /> Address I License# <br /> I <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address I License# <br /> I <br /> MECHANICAL COMPANY <br /> SIGNA7URE REGISTERED Y/ N FEE CURREN Y!N <br /> i <br /> Address I License# <br /> � <br /> 07HER COMPANY <br /> SIGNATURE R�isr�rteo Y/ N FEE CURREN Y/N <br /> i <br /> Address I License# <br /> IIIIIIIIIIIIIII � IIIIIIIIIIIIII11 � 1111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)s�t of Energy Forms;R-O-W Permit for new construdion, <br /> Minimum ten(10)working days after subm'dtal data. Required onsite,Construdion Plans,Stormwater Plans w/SiR Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit foi subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a LffelSafety Paga;(1)set of Energy Forms.R-0-W PermR for newconstruction. <br /> Minimum ten(10)wnrking days after submittal date. Required onsite,ConsWdion Plans,Stortnwater Plans w/Sik Fence installed, <br /> Sankary Fadlities&1 dumpster Site Work Permit foi all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> - • 1 1 f f 1 • • 1 • 1 1 • � � 1 f t� 1 Li ' {ii..l ' 1 � f 1 1 f 1 1 t 1 • Y • <br /> Directions:• <br /> Fill out application completely. <br /> Owner 8 Contrador sign back of application,notarized � <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> " Agent(for the contrador)or Power of Attorney(for the owner)would be sameone with notarized IeHer from owner authorizing same <br /> OVER THE COUN7ER PERMITTING (Front of Appliption Onty) <br /> Reroofs if shingles Sevters Service Upgrades AIC Fences(PlotlSurveylFootage) � <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> I <br />