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' a��-�ao-oo20 -- Ciry of Zephyrhills Permit Application Fax-61�780-0021 <br /> '1 . Building Department <br /> ; Date Recelved Z� S��� Phone Contact for Permil8ng <br /> Owner's Name D r r� Owner Phone Numb <br /> l 1� 33S4L <br /> Owner'sAddress y�3t�'f'�,�b�.�3 � �a f ,Ils �� OwnerPhone mber ��i-��o��f()'r'J,�7- <br /> Fee Slmple Titleholder Name Owner Phone N 6er <br /> Fee Simple TiUeholder Address <br /> � JOBADDRESS ���� ��� �' i� rV1� S �` ✓�3S�'I2 LOT# � <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROPI PROPERTY TAX NOTICE) <br /> WORK PROPOSED �NEW cONSfR B ADDlALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q�SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q \��'�' <br /> DESCRIP710N OF WORK 5 I�.A�1 L.I1�1�43: 6til C�C�y�1A J�CfP.�nfpfi�cl 1.103�'- C j' QY1� � <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> BUILDING $��,� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ j/� <br /> i � %l �,) <br /> � V� <br /> QMECHANICAL $ VALUATION OF MECHANICALINSTALLATION � <br /> i <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> 4 <br /> BUILDER � + � COMPANY �P�'12� �Ni1Z�' <br /> SIGNATURE �' REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE t�cistFam Y/N �E cuw�n Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE rtEGis�rtm Y/N FEE CURRQ. Y/N I <br /> Address �cense# <br /> MECHANICAL COMPANY <br /> SIGNATURE rtE�isreaeo Y/ N FEE CURRE� Y/N � <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE r��is7�rtm Y/ N FEE CURRE� Y/N <br /> Address Lfcense# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bulding Plans;(1)set of Energy Forms;R-aW Pertnit for new consWc6on, <br /> Minimum ten(10)vrorking days after su6mittal dale. Required onsite,Construction Plans,Stortnwater Plans w/S�lt Fence installed, <br /> Sanitary Fadlities 8 1 dumpster,Site Wark Pertnit for subdivisionsllarge projects <br /> COMMERCIAL Attach(2)complete sets of Buiiding Plans plus a Life Safety Page;(1)set of Energy Fortns.R-0-W Pertnit for new consWction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructian Plans,Stortnwater Plans w/S�7t Fence installed, <br /> Senitary Facilities 81 dumpster.Site Work PertnR for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMR Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW consWction. <br /> Directlons:• <br /> Fill out applicadon campletely. <br /> Owner&Cantrac[or sign back of application,notarized <br /> If over 52500,a Notice of Commencemant Is requlred. (AIC upgrades over$7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone wilh notarized letter from ovmer author¢ing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shinglas Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> DHveways-Not over Counter If on public roadways..needs ROW <br />