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a�3asaoozo City of Zephyrhills Permit Application Fax-813-780.0021 <br /> Building Department � <br /> ; • <br /> Date Recelved 3 �2.q f� �f 3 �j l� _ (p,� 3 `7 <br /> �Phone Contact.for Pe�mittfn ;_ <br /> Owner'a Name �YL� �J �� Owner Phone Number <br /> Owner'�Address ���� L.� Owner Phone Number <br /> Fee Simple Tideholder Nlame �� '� ` Owner Phone Number <br /> ,,,�l <br /> Fee Simple Titleholder Address -' <br /> JOBADDRESS 3a�� � LOT# � <br /> SUBDIVISION PARCEL ID# � <br /> - .� (OBTAINED FROM PROPERTY.TAX NOTICE) ' <br /> WORK PROPOSED '*NEW CONSTR ADD/ALT Q SIGN' Q Q DEMOLISH <br /> - INSTALL e - REPAIR , <br /> PROPOSED-USE Q SFR [�, COMM Q OTHER <br /> TYPE OF COWSTRUCTION-". Q � BLOCK �' �Q FRAME Q' STEEL Q' <br /> DESCRIPTION OF WORK /�'t � <br /> BUILDING SIZE - SQ.FOOTAGE �2� S , HEIGHT , <br /> � QBUILDING $ ElM'A�i�-.y - SL^e-•.. <br /> - VALUATION;OF 70TAL CONSTRGCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS'ENERGY Q W.R.E.C. <br /> QPLUMBING $ n '�P� , / <br /> � `, �� <br /> QMECHANICAL $ VALUATION OF MECH/1NICAL INSTALLATION �� <br /> QGAS - r�' ROOFING Q SFECIALTY Q. - OTHER: . - � /(�✓ <br /> � � !/ <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO � <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� 'Y/N' <br /> Address � License#' • <br /> ELECTRICIAN: COMPANY•' �`� - ' _ <br /> SIGNATURE y REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres� � ' � , • License# � <br /> PLUMBER � .COMPANY. � ;, . . �. <br /> SIGNATURE ' � .REGIS7ERED � Y./ N F,EE CURREK� Y/N � <br /> Address License# <br /> MECHANICAL �� ' ' .., COMPANY � - <br /> ''$IGNATURE � �_ REGISTERED, Y./,N _ Fee curtrt�n .Y/N- <br /> Address�" ` � � ' � ` � License# ' <br /> OTHER ' e� � COMPANY „.{, <br /> SIGNATURE � � � '� 'REGISTERED' � Y/�N.,, � FEE CURRE� +Y/ <br /> Address � •( �?---' �.=2:;:� '�.' �C 3 52j Lfcense# L'.�-C —�S?� ��— <br /> - RESIDENTIAL� •"`Attach(2);Plot�,Plans;..(2)�sefs:ofBuilding"Plan's;(-1�)sef of Energy-Fortris;`R=0-W'Perrnif farnew-constiuction, _ � <br /> : Mlnimum;ten,-(�1.0)yworking days aftec_subriiittal:date:�Required,onslte;�ConstiucUon°Plans;8tomiwater`Plans w/Silt Fence installed, <br /> ��SanftaryFacilides;&�:1�dumpster_Site`Work;Permit�forsubdidislons/largepro)ects � - '� � <br /> COMMERCIAL Attach(3)�eomplete sets'of Builiifng'Plans'plus a'Ufe Sefety�Page;(1)set of Energy Forms.R O-W Pertnit for new oonstrucdon. <br /> Minimum ten(10)working days after submittal date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facilides 8 7 dumpster.Site Work Permlt for all new'projects::All commerdal requlrements must meet compllance <br /> SIGN PERMIT AttacFi"(2)'sets of Engtneer.ed;Plans:,:,,.,:�r2,',.::::�_ :�:. � , . • , , <br /> ""'PROPERTYSURyEY reguired for all IVEW qonstrucUon. . .. <br /> Directlons: ... - <br /> FIII out applicadon completely. <br /> Owner 8�ContracMr sign back of applicatlon,notarized <br /> If over 52500,a Notice of.Commencement is required. (AIC upgrades over sT500) <br /> ':.,.:�!'"y.�.c;, , <br /> " qqent(for the�contraato�j or Power'of`Attorriey(fo�the ownerj would be someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER.PERMITIING�--�—�--(Frontof-Applicallon Only)`• _ ' <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSunrey/Footage) <br /> Drlveways-Not over Counter tf on public roadways..ne'eds ROW � <br />