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813-780-0020 City of Zephyrhills lPermit Application Fax 813-780.0021 <br /> ` Building D;epartment <br /> Date Received Phone Contact for Pi rmittin 1 � �c�2- — 'J'��� � <br /> Owner's Name �L` �/� !� � ! Owner Phone Number �f�' �!�,_,7 <br /> Owner's Address � �. ,� ��L, I Clwner Phone.Number ^ � <br /> Fee,Stmple Titlehatder Name �� i Owner Phone Number � � <br /> � i <br /> , i <br /> Fee Simple Titleholder Address � � <br /> JOB ADDRESS ����� Z-l//f'1�� /�L �>,,�i�`G°��, � �j'��� LOT# �� <br /> i <br /> SUBDIVISION JIYe°tQ GJ�fCS� PARCEL tD# � �� �� L1�0� ��Q� ��� <br /> j (QBTA4NED FRQM PRbPERTY 7AX NQTICE) <br /> WdRK PROPdSEQ , e NEw GoNSTR� ADQlALT I Q SIGN Q (� DEMOLISH <br /> INSTALL REPAIR � <br /> PROPOSED USE Q SFR Q C4MM �0 OTHER <br /> TYPE OF CONSTRUCTfON Q BI.00K �J FRAME � Q STEEL C] <br /> I <br /> DE3CRIPTION OF WORK � L ��f ��vr.e T" a3; �� /�l�l�'�rri S l �' � Gp d �it1 <br /> BUILDING SlZE � � SQ FOQTAGH�_ '' 1 MEIGHT C��� <br /> QBUILDING ��� VAI.UATIOiV OF TQTAL GONSi'RllCTIQN <br /> QELECTRICAL $ �� AMP SERVICE j Q PROGRESS ENERGY Q W.R.E.G. <br /> OPLUMBING � � <br /> '! <br /> �MECHANiCAL $ r��n�.. �� VALUATION OF MECHANICAL INSTALLATION ��Z� ? 2 <br /> �� 7 <br /> QGAS Q ROOFIM1IG Q SPECIALTY!� OTHER <br /> FINISHED fLOOR EIEVATtONS FLOOD ZONE AREA QYES NO <br /> �_� , <br /> ; <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> AddresS I l.icense# � � <br /> i <br /> � <br /> ELECTRICIAN COMPANY <br /> SIGNA'NRE REGI57ERED Y/ N FEE CURRE� Y/N <br /> Address ! l.fcense# � ( <br /> PLUMBER COMP� <br /> SIGI+iATURE �_�..,._.,_ �-__� REGIS7ERED Y/ N FEE CURRE� Y/N <br /> Address i License# ( � <br /> MECHANiCAL y�',,�=; � e ,l conna�►Mr ���1,���o,o�JN�' ��5�''���-�.�-�j�/� <br /> I SiL3A1ATUF2E +G��f/`'� ���✓t✓ REGISTERED Y J N FEE CURRE� Y/N <br /> . <br /> � <br /> Addre�s 7��� /lenr /2� J7'�-,1"� License# ��—/������"� ! <br /> ,_ � <br /> OTNER COMPANY <br /> SlGNATURE RE6157ERED Y I N FEE CURREA Y J IV <br /> Address License# � �ii� _� � <br /> RESlDENTIAl. Attach(2)Plot Plans;(2}sefs of Buitding Pians;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minlmum ten(1Q)working days after submittal date. Required onsite,Gonstruction Plans,SMrmwater Pia�s wt S�lt Fence installed, <br /> Sanitary FaGlitles&1 dumpster,Site Work Pennit for subd(vislonsAarge proJects <br /> CdMMERCiAI. Attach(3}camptete sets of Building Plans pius a Life Safety�Page;(1)set of Energy Forms.R-O-W Permit far new consUucUon. <br /> Minimum ten(1Q)workfng days after submlttai date. Requlred onsite,Construatton Pians,Starmwater Pians wl Sflt Fence lnstailed, <br /> Sanitary Facilides 8�1 dumpster.Site Work Permit for all new proJects.All commerGal requlremenks must meet com�!lance <br /> BtGN PERMiT Attach(2}sets of Engineered Plans. <br /> '•"PRQPERTY SURVEY requlred for ati NEW constcuo@on� <br /> Directians: � <br /> Fltl out appfication completely. � <br /> Owner&Contractor sign back of applfcatlon,notarized <br /> If over 52540,a Notice af Cammenaement Is requlred. (AIC upgrade i over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the:owner)wauld be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Fronk of Applicatiori Only) � <br /> Reroofs if shingles Sewers Service Upgrades )t%C -° Fences{F'Iot/SurveylFoatage) <br /> ,. � , - <br /> Driveways-Nat over Counter if an public roadways..needs ROW. .,, „ . � <br /> , � <br /> � <br />