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a�saso-oozo � City of Zephyrhills Permit Application Fax-813-780-0021 <br />� Building Department <br /> I Date Received Phone Contact for Permitting �� � � V���Q� l e�� u� � , <br />� <br /> Owner's Name n V� ���CI�- Owner Phone Number V r� �� 1-���1 <br /> Owner'sAddress ��d �� �UCG-l`j ��S (.1;• �� (h�IIS �:JS} OwnerPhoneNumber <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3�a�3 �-uC Q� }U S �(• 6/�h ( h;��5 F� 3354 a, LOT# � <br /> SUBDIVISION �I�T��O(.J�� PARCEL ID# VG���'(� `a� 'V�� �' v��� ����� <br /> (OBTAINED FROM PROPERTY TAX NOTCE) <br /> WORK PROPOSED e NSTALLSTR B REPAIR � SIGN � 0 DEMOLISH <br /> PROPOSED USE � SFR Q COMM � OTHER <br /> . TYPE OF CONSTRUCTION � BLOCK _ Q FRAME � STEEL � <br /> DESCRIPTION OF WORK ��� ��'" �''��U� �.5 S uQr�e 5 Q� j�a,l� s�l n�l� � <br />' BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ )��O� —" VALUATION OF TOTAL CONSTRUCTION <br /> � <br /> QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY 0 W.R.E.C. <br /> OPLUMBING $ �� <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION l `�'� <br /> � <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPAfdY <br /> SIGPJATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER 1I��p I `, COMPANY � V.���-(� "Ov' '� �nC ' <br /> SIGNATURE ��C � I Y�`^-� LL1�� � REGISTERED Yj N FEE CURRE� Y/N <br /> Address � to't(J �J�1 S� �1 � h��� 5 3�J y� License# CCC f 3 a SSU S <br /> � � � e � s � e � � � e � � � � � � e � � � � � s � i � � � � � e � � � � � i � � � ii � � � � � � � � � � � � � � � � i � � � � e � <br /> RESIDENTIAL 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/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(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/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster Site Work Permit for all new projects.All commercial requirements must meet compliance I <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERT'Y SURVEY required for all NEW construction. <br /> . . . . .�_. <br /> Directions:.�'. _ -. .. _ , � , -, •..�- , • .- . . .. : .. .. . .. .. <br /> Fill out a lication�com leYel , _ � � ' - ' " <br /> PP. P Y�_; , . <br /> Owne�.&Contractor sign.back,of,application,notarized � -� � <br /> If over$2500;,a:Notice of.Gommencement is,required. (A/C upgrades over$7500) ' " �•�,; -_ ' �•� . - ' <br /> " Agent,(for the contracto�)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 if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />