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\ <br /> ,si�aaso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ► Building Department <br /> Date Received �� - d t.� � a,p� � phone Contact for Permitting � �3 C°a`� - ���O LO <br /> ..a,.,_�mm�.,.�, ._._,�-,-.,._.. .., . . ..a-_.�r�.,m.,,,.,, . �, , � _„e.. w,„ � M_ .,, ,. ._ .��, <br /> Owner's Name C��d � �1q'Wl�-S 4- !)� ���E Owner Phone Number 8�� ' �]$$ - (�'�`c3� <br /> Owner's Address 3� J� � �� ���' Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOBADDRESS �7 05 � � U'� 14"�"e 2{ph rh� ��s � r � 3 as�i a LOT# � <br /> SUBDIVISION PARCEL ID# � 1 a �J �a 1 ~b O ) (� � I S � b D - o o!U <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e WSTA�NSTR � � 1 REPAIR � SIGN Q MOVE Q DEMOLISH <br /> u <br /> PROPOSED USE Q SFR 0 COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL Q OTHER <br /> DESCRIPTION OF WORK � I � � � � � �-` ��"e'� S C �1 r i� 1� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> '^ - -- <br /> � BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> Q ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> Q PLUMBING $ <br /> Q MECHANICAL $ ���� . Q� VALUATION OF MECHANICAL INSTALLATION r_ � rn� <br /> �`�J V G <br /> � <br /> Q GAS Q ROOFING 0 SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES Q NO I <br /> BUILDER COMPANY � <br /> SIGNATURE I REGISTERED Y/ N FEE CURRENT Y/N i <br /> Address License# � I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> i SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address �— � 1 License# � <br /> MECHANICAL `f n ���� COMPANY �"«� IT�'r C D f1 tLr �'�O►+1 <br /> SIGNATURE �� li REGISTERED Y/ N FEE CURRENT Y/,N <br /> Address 3�j O� Of o(-C PRf1�. ,r ��3U f� 3310 License# C �-� � G LJ a�'1 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> �,�•���P�.����.��� _ <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 /> ��,�.� .—���m �,m - � -- - ��� ��� �s � - � r �� . <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. (A/C 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(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />