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. . • _ . ` <br /> ais-7so-oo20 " � ��, �City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � ' ' . , . � .°Building Department <br /> ..' _,..°.� ..:• . � ,.. ..� ;.. ...,, . ,. . . <br /> Date Received <br /> Phone Contact for Permitting - <br /> ------- - - �:�� --- -WA�.m- <br /> Owner's Name��U � �� (1 II"t��'e�m Owner Phone Number � [3' V 7Yp o�•I� �7�ry� F <br /> Owner's Address 3 U �v� L-►'�W r3-(�C� � 1-DO� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOBADDRESS O�LQ L7�}"1J��Y���� La0 LO"I'# � <br /> SUBDIVISION �v �l� P�5 �o � ��O a �- �'�PARCEL ID# �� �a�� �� '�� t�� -0 000 O - 0��a d <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN Q MOVE � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR � COMM Q OTHER <br /> TYPE OFCONSTRUCTION Q BLOCK Q FRAME Q STEEL Q OTHER <br /> DESCRIPTION OF WORK � C G � °5 �C�✓1 ��! cJ'�"�� l�d c�a M W'1� V I �- }7 14C� �'L h� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> e^�^°�^^m�r ^'�"'�^^a --...._��°s�e�nm�......... ..._.��am�m�r,�^^�_,_.....��m�v�;uw�:,�, _ �,�,a.�m^��. w...�����, <br /> ..,u..� .... ...........^,.��� , n .� <br /> � BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> Q ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> Q PLUMBING $ � <br /> � MECHANICAL $ `�v VALUATION OF MECHANICAL INSTALLATION �I �I� <br /> 'ig `1S ��� <br /> � GAS Q ROOFING Q SPECIALTY � OTHER � � <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA �YES QNO <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 /> MECHANICAL � — COMPANY �-e.�- 1r ` Un �� ���✓� �� <br /> SIGNATURE �/ REGISTERED Y/ N FEE CURRENT Y/,N <br /> Address 3 0� c d� p,�2.j' �( �� (� License# l, /r 5 d�a�I <br /> OTHER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> � ,..� .,.��__.�_ w � _,...w_�_�=mar_ ... .,.... ____e_.._�. ...�... . - <br /> -- ._-----,� , .. _ __..._____.._. _ _ ._— � � <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 Plans,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 /> w�u�aSd�o s.�aex r���� — Wyq�a� ,� ——��aa��i,'�Fx�— <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. (A1C 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 />