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� • 81&78Q0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Departmenl <br /> i Date Received phone Contad for Perm't�ng � — <br /> t6 � <br /> 1 1 1 1 1 1 1 1 � / <br /> Owner's Name L I . Ownar Phone Number ��✓'^ 7!��!l�� i� <br /> Owner'sAddress J`�� /�i1Z �'�`�( OwnerPhoneNumber 3�a-��l- .5z� - s��� (�'�'^"'l <br /> �.?.JP� � C1Ji�l/l�i/�["��1�• <br /> Fee Slmple Titleholder Name 1 ` Owner Phone Number ,� <br /> Fee Simple TlUeholder Address <br /> JOB ADDRESS <pC S p< L'{/f2 Q�{iL . LOT# r.� <br /> SUBDIVISION PARCEL IDp .1�� ' �'�d.S�^�d�� •��� <br /> (OBTAINED FROM PROPERTY TA%NO110E) <br /> WORK PROPOSED NEW CONSTR ADD/ALT 0 SIGN Q Q DEMOLISH <br /> e INSTALL e REPAIR <br /> PROPOSED USE Q SFR Q COMM Q�OTHER — � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK ' <br /> BUILDINO SIZE S�FOOTAGE �� HEIGHT � <br /> ��r�T� i i �Tr�� � � r n � r� � � � � � e � i-n � <br /> Q BUILDING S �� ,/1' Q VALUATION OF TOTAL CONSTRUCTION <br /> �rQ <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �— N� � <br /> �,�,p��s ✓ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION y <br /> ,�'(CJnG'7Ur"'� OZ.?��� <br /> QGAS ROOFING Q SPECIALTY 0 OTHER `l��/o�/y <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> �.�.�_. <br /> BUILDER COMPANY <br /> SIGNATURH REGISTERED Y/ N F�CURaEn V/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE r�Gisr�eD Y I N FEE cuar�n Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIONATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> /lddress License# <br /> MECHANICAL COMPANY <br /> SIGNATURE aEcisrat� Y/N F�cuatxEn Y/N <br /> Address � License# <br /> OTHER COMPANY <br /> SIGNATURE GISiEReo Y/N �curu�n Y/N <br /> �' IIdress � . Z �/l�'l.t_Y.Gd/�iLlcense# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIt1111111i1111111111 <br /> RESIDENTIAL Attach(2)Plot Pians;(2)sets of Buflding Plans;(1)set of Energy Fortns;R-O-W Pertnit for new consWction, <br /> Minimum len(10)wo�king days after subm'ittel date. Required onsite,ConsWction Plens,Stonnwater Plans w/Silt Fence installed, I <br /> SaNtary Facilities 8 1 dumps[er,Site Work Permit for subdivisionsllarge projects I <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)se[of Energy Fortns.R-O-W Permit for new constructlon. ' <br /> Minimum ten(10)working days after submittal date. Requirad onsite,ConsWcdon Plans,Stormwater Pians w/Silt Fence instalied, <br /> Sanitary Facilities 81 dumpster.Site Work Pertnit tor all new projects.All wmmercial requirements must meet camplience <br /> SION PERMIT Attach(2)sets of Engineered Plans. <br /> '•"PROPERTY SURVEY required far aIl NEW constructlon. I <br /> Diredlons:• <br /> FII out applicaUon completely. <br /> Owner&ConUactor sign back of application,notarized <br /> I(over i2500,a Nodce of Commancement Is required. (A!C upgrades over 57500) I <br /> " Agent(for the contractar)or Power of Attomey(for the owner)would be someone with notarized letter from ovmer authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contrad required) <br /> Reroofs if shingtes Sewers Senrice Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />