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813-78D-0020 City of Zephyrhills Permit Application F�$��-�eo-ooz� <br /> �� � Building DepartmeM <br /> r <br /> Date Received Phone Contad for Pertnitting <br /> Owners Name � rt I 1 �C�YI C..e_ _ �Owner Phone Number 13 3�S�'�i i <br /> Owner's Address �� (� J{p 3�Oswner Phon Number / <br /> Fee Simple Titleholder Name Owner Phone Number / <br /> Fee Simple Titleholder Address <br /> JOBADDRESS �� I I� �� • � S r J� 7 �T# � <br /> SUBDIVISION / PARCEL ID# � '�6-aJ-- ao�o�" �S dQ^Q (�C� <br /> (OBTAINED FROM PROPERN TAX NOTIC� <br /> WORK PROPOSED e NEw CON57a e ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK , • l <br /> % <br /> BUILDING SIZE SQ FOOTAGE I� HEIGHT � <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION /L�] <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> / � 7 ( <br /> QPLUMBING $ ��' I ��� <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br />, o � � � ( ��.S" <br /> I :��t5z�o n VD� , � (� <br /> QGAS �� ROOFING Q SPECIALTY � OTHER� � � l� / � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES NO C�^ � <br /> BUILDER •COMPANY• �� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTFRED Y/ N FEE CURREA Y/N <br /> Address License# <br /> PLUMBER COMPANY <br />, SIGNATURE REGISTFRFD Y/ N FEE CURREn Y/N <br /> Address License# <br /> MECHANICAL COMPANY � <br />� SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY � � C3]'LS��G<-L�b�.��b , 0.Ny J�Y�-�,_, <br /> SIGNATURE � � REGISTERFD N I FEE CURRE� Y/N <br /> f � F./ �� <br /> Address 37�s V C � f'_ �h�Y�t�(5 �-I�nse# Cc c.13 a 7 � <br /> IIIIIIIIIIIIIIIIII111111111111111111111111IIIII11111111111111111111 <br /> RESIDEN7IAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)vrorking days a8er submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Pertnit for subdivisions/large projec[s <br /> COMMERCIAL Attach(2)complete sets of Building Plans pius a Life Safety Page;(1)set of Energy Fortns.R-0-W Permit for new construction. <br /> Minimum ten(10)woricing days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 81 dumpster.Site Work Pertnit for all new projeds.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW consWdion. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner author¢ing same <br /> COUNTER PERMITTING (copy of conVact required) '`/`./v v_ 1 � <br /> Reroofs if shingle Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW 1 <br /> :=_�`'��`°'4'� EVA MARIE MARSHALL <br /> A. �5 <br /> ' ' MY COMMISSION#FF080465 <br /> . ��. .- <br /> �",'e`o«drA'' EXPIRES April 11, 2018 <br /> ��t�7)398-0153 FloridallotaryService.com <br />