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sisaso-oozo � � City of Zephyrhills Permit Application Fax-813-780-0021 <br /> • Building Department <br /> '! <br /> Date Received � � �� � ao� Phone Contact for Permitting � (Jl a�� — 1��`"c <br /> �;.�.,mm., - -- - -- -- - - <br /> .,...��-__�.,,..- ,�. � ,...,w ., e�.,�,� , . ,� �m . �,r.,..,�a . <br /> ��S S�w►w��e:� S g� �- 3� S—��SS <br /> Owner's Name Owner Phone Number <br /> Owner's Address (�53 LI �D X j�OV�' J�� Owner Phone Number <br /> Fee Simple Titieholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �3 �Ur` ���U � �� LOT# �a <br /> SUBDIVISION � ���`� � �-S ��Y`r`cf�-�� PARCEL ID# �, � a �- a� - 6� a� - aoo o� - �Sa e <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR ADD/ALT � SIGN 0 MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 0 SFR � COMM Q OTHER <br /> TYPE OFCONSTRUCTION Q BLOCK Q FRAME � STEEL Q OTHER <br /> DESCRIPTION OF WORK ���� � U�.l�� JTU�'1 �O�-`e-� h P <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> Q BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> Q ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> Q PLUMBING $ � ��(�� <br /> � MECHANICAL $ � n�� p v VALUATION OF MECHANICAL INSTALLATION <br /> '1 1 ( <br /> � �� <br /> � GAS Q ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES ONO <br /> a ��, �. �� = - ° - <br /> - ����_��� <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# �— <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address �— ^ 1 License# � <br /> J `/� I <br /> MECHANICAL �� I �1 COMPANY `��� V`�'� � C O�'� cL� �0✓1 i <br /> SIGNATURE �J REGISTERED Y N FEE CURRENT Y/,N <br /> Address �CJ�1 C,d�{��f'e-2� P�(� �( �13 C� License# C�7-C� 0 D y�lp <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpster <br /> COMMERCIAL Attach,(3)sets of Building Plans;(1)set of Energy Forms. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plahs,Sanitary Facilities&1 dumpster <br /> All commercial requirements must meet compliance. <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ***'PROPERTY SURVEY required for all NEW construction. <br /> �:a mar �i — �^ —� .,.�� a � -- � <br /> .:a <br /> Directions: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$5000) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />