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� <br /> � <br /> � a��-�eaoozo City of Zephyrhills Permit Application -a�saso-ooz� <br /> ; ' Building Departrnent <br /> � Date Recelved phone Contact for Pertnittin 7 8 S�O _ �a O <br /> i , <br /> Owner's Name 17(�wz� � �2l1C0/1 G nwf�'/) Owner P ne Number ��I� 1p0 <br /> � Owners Address 37 N�{C� �QU I`2� H an�Mook D1- Owner Phone Number <br /> � Fee Simple Titleholder Name Owner Phone Number <br /> I Fee Simple TitleholderAddress <br /> JOBADDRESS 7y�{O (�GvlL'� Nan�naocic Ar LOT# .30 ' <br /> SUBDIVISION �4�L.�4/► `�4S'C o�. PARCELID# 3y' /�� p11� �1.30�00000� �3S0 <br /> � � (OBTAINED FROM PROPER7Y TAX NDTIC� <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br />, PROPOSED USE Q SFR Q COMM � OTHER Q(7 V. <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> I <br /> I DESCRIPTION OF WORK Zn fvWld �O/1CJ+e'{P S�I�M Mi IL c'�� <br /> ' BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> i <br /> I <br /> QBUILDING j S �1/L �'w VALUATION OF TOTAL CONSTRUCTION <br /> oC T <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> � � � � <br /> � QPLUMBING $ �� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I ��� <br /> W`� ��%1�. <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER ��"' � �� <br /> , FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO O� <br /> , �J /� j <br />� BUILDER COMPANY � �� rm�. CI�@��_I�QAS 1 �G <br /> SIGNATURE REGISTERED Y/ N FEE CURREh Y/N <br />� Address 14'15.� 1'l S 20l' S1i 3�{(c I ucense# GPG/y S8�o3�f <br /> ELECTRICIAN L�` �� � COMPANY 5�16 C�h'lRrLlw� <br /> � SIGNATURE ' � _ - �cis�n Y/ N �E cUr�n Y/N <br /> � <br /> aadress /oroS Nc,d t ihx'Nv4 �'c. 3 49 u�ense# G �3oa�/o( <br /> PLUMBER �� COMPANY U4C�(, cJ'Cl Pu�ti C reafi o�s� Ltc <br /> SIGNATURE rtEcisrErtEo Y/ N �E cuwiEn Y/N <br /> nddress 1 N a53 �-1 S � � S}{ �C 3W I O �icense# Gf�G /YSS(o37 <br /> MECHANICAL COMPANY <br /> SIGNATURE rx�cisTef�o Y/ N r�cuw�. Y/N <br /> Address License# <br /> OTHER COMPANY - <br /> f SIGNATURE rtE�isreREo Y/ N FEE CURRE� Y/N <br /> iAddress License# <br /> � Illllllllllllllllllllllllllllllllllll,lllltlllllllllllllllllllllllll <br /> I RESIDENIIAL 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)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Sitt Fence installed, <br /> , Sanitary Faalities&1 dumpster,Site Work Pertnit for subd'rvisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy.Fortns.R-O-W Pertnit for new conshuction. <br /> ' Minimum ten(10)working days after submittal date. Required onsRe,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> ! Sanitary Facilities 81 dumpster.Site Work Pertnit.for aIL new projects.All commercial requirements must meet compliance - <br /> SIGN PERMIT Attach(2)sets of Engineered Flaris. <br /> ""PROPERTY SURVEY requi2d for all NEW consWction. � <br /> Directions:• <br /> Fill out application completely. � <br /> Owner 8 Contractor sign back of appiication,notarized <br /> ' If over Sz500,a Notice of Commencement is required. (AIC upgrades over§7500) , <br /> I " Agent(for the contractor)or Power of Attomey'(for the ovmer)would be someone with notarized letter from owner authoi¢ing same <br /> OVER THE COUNTER PERMITTING (wpy of contract required) <br /> i Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> I -• - <br /> � Driveways-Not over Counter if on�public roadways..needs ROW � ' �""� �� � � , <br /> I ,, ..,.�%' ; -. � ° - , '. ,..r,�'''. � , u. ,. . , : . •, �, <br /> If � ' .. . , . . , �. ' _ , � . Y.. ..r _. ..., ., _ ., . -_ • <br />