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sis-7aaoozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br />' ` Date Received � a' phone Contact for Permitting ( � ✓ C -O O v <br /> ,--r-�-.�_.i...�_�_�_�_ - - - -- ...7-iTf <br /> Ownor's Name �Q� � �`1"r Owner Phone Numher ���7��� <br /> Owners Address �V3�� l.i"'� Owne�Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number • <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS J� � ��9L �1`� ��� LOT# � <br /> SUB�IVISION �r/WO� ��S PARCELID# � � � ��� ���0���`"" <br /> �.,// (OBTAINED FROtd PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW coNsrR� ADDlALT � SIGN Q 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE �� SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION �' BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK /I I � � �W ��I ? G O <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT p <br /> rrr-e-r-r'rr'e�e-me�i�t- r'rr'rrrT1"e�e� <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br />, QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � <br /> �ECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I � O� <br /> \ <br /> � . <br /> �� � <br /> QGAS Q ROOFING Q SPECInLTY 0 OTHER A <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO � <br /> -.-.�-.-..-. �:..r....-�-o-.-, .-.-.-.-.-a-,�-.-.-.-6-:-.-.-.-.-.-.-.-.-.-.-r..-r�--�.�-r.-.-.-�� <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# I <br /> ELECTRiCIAN COMPANY <br />� SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTEREG Y! N FEE CURRE� Y/N <br />, Address License# <br /> MECHANICAL _ 1 Ip� COMPANY � �vS� y � <br /> SIGNATURE v�.. —r 2 REG�STERED Y N FEECURRE� N <br />�� Address / �� I � License# G � � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRER Y I N <br /> Address License# <br /> 1lIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111111 <br /> RESIDENTIAL Altach(2)Plot Plans;(2)sels of Building Plans;(1)set of Energy Forms;R-p-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w!Silt Fence installed. <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisions�large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fom�s.R-O-4V Pennit for new construction. <br /> Minimum ten(t0)worki�g days after submittai date. Required onsite,Construction Plans,Stortnwater Pfans w1 Si€t Fence installed, <br /> Sanitary Facilities&t dumpsier.Site Work Pennit for all new projects.All commercial requirements musf ineet compliance <br /> SIGN PERMIT Altach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for ai!NEW constniction. <br /> �:--..-r:--rl--�F:-r.��.�-.�-.-.-r.-o-{-1-6-�-L.:.-..-.-..,��-.-ra--r4-Ie-6..L..�:...-��..�.-1..0-:�-.-r.T�9--�1-H4-.�8- <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> Directions: � <br /> Fiil out appiication completely <br /> Owner&Contrador sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (CJC up9rades over 57500) <br /> " Agent(for the contractor)or Power of Attorney(for the owner)wouid be someone with nofarized Ietter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingies Sewers Service Upgrades A/C Fences{PIoUSurveylFootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />