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s��-�eo-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> .; j Building Department <br /> Date Recelved Phone Contact for Pertnitting <br /> -rr r-�-rrrr / -n-rrr <br /> Owner's Name C=`1 �f" J�� L C.� Owner Phone Number � ' 7 7 Y-���� <br /> Owner's Address O t ���/Ll� � s!►'�yin-L �1 Axrner Phone Number <br /> � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titieholder Address <br /> JOB ADDRESS �.7 Y S � Sr 3� S G� S�/L/��C.�. LOT# � <br /> SUBDIVISION PARCEL ID# /�"Z 6'�.�" O 0 L/V — �O$ c7(7 � tJC)�0 <br /> (OBTNNED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTi�� ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL �g� REPAIR <br /> PROPOSED USE � SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK ��6a� uV�� <br /> BUILDING SIZE � L�� SQ FOOTAGE� HEIGHT � <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> � 3 do ,a° <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER `� COMPANY �✓P�1/ ' I'3 r0 0✓1 fT�t�GTi`o i✓ <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �,�U 3 /�+�+� !� �1,n/ � License# C��- ��� � ,� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE r�Gis�r�o Y/ N F�curtaen Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IIIIIIIII111111111lIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum ten(10)working days after subm"ittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence instalted, <br /> Sanitary Facilities 8'I dumpster,Site Work Pertnit for subdivisions/large projecLs <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortns.R-0-W Permit for new construcfion. <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 Pertnit for 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 /> Directlons:• <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of applicaUon,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500) <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 if shingles Sewers Service Upgredes A/C Fences(PIoUSurvey/Footage) <br /> Drlveways-Not over Counter if on public roadways..needs ROW <br />