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� � a�3-7ao-ooza City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � Building Department �4� t�5� <br /> P <br /> Date Received, , phone Contact for Permitting -- <br /> cr's Name s Owner Phone Number J ',�`� <br /> t}wner's Address pwner Phone Number,����^� � <br /> Fee Simple Titleholder Name Owner Phone Number ���� <br /> Fee Simple T�tiehatdec Address � <br /> JOB ADDRESS �" �'k�� � LOT# L�,_.J <br /> �UBDIVISION r�'��kyti L31�E+N �-r)F1UC�0'�^� 1 PAi2CEL ID# j} ` �c?• tSJJJ= �! <br /> {48TA{iJEQ Fi24M PRpPERTY TAX NOTICE) <br /> UUORK PROPOSED NEW GONSTR ADDtALT C] SIGN Q MOVE Q DEMOLISH i <br /> e iNSTRL.L REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER f.-Q <br /> TYPE QF CONSTRUCTtON Q BI.00K � FftAN1E Q ST�EL � OTH�R [^— � <br /> DESCi2tP710N OF WORK y � ' � i.�t.� �"r � <br /> BUILDING S12E ���� S4 FOOTAGE .,� "��,"� �� HEIGFIT ��� <br /> �� BUILDING $ p / VALUATION OF TOTAL CONSTRUCTION <br /> 1��.,� � <br /> � ELECTRICAL � � AMP SERViCE � PROGRESS ENERGY Q W.R.E.C. <br /> I <br /> � PLUMBING � � � � <br /> 0 MECHANICAL $ VALUATI4N OF MECHANICAL iNSTALLATION <br /> �----� <br /> 0 GAS � ROOFING Q SPECIAL.TY Q OTHER <br /> FlhJlSHEd FLOOR ELEVATIONS � � FLOOD ZONE AREA QYES ONO <br /> � <br /> � <br /> , BUILDER COMPANY �����c� .1��k'L, � _��c_ � <br /> ; SIGNATURE REGISTEREp / N FEE CURR T Y N � <br /> Address t'�J'Rl� t,,�� �� �-��� 1..+ �� c�i, c�.?�3 License# +(,�C, �j�,`��;��,. � <br /> ! <br /> Ek.ECTRICIAN CQMPANY <br /> iSlGNATURE . Rs��sr�aEa Y/ N ; FEE CURRENT Y/N <br /> Address License# �- -� <br /> PLUMBER ' COMPANY <br /> ; SlGNATURE RECalSTEREi3 Y l N = FEE GURRENT Y/N <br /> Address License# �— � <br /> "�ECNANICAL COMPANY <br /> �NATI3RE REGlSTERED Y 1 N FEE GURRENT Y/N <br /> Address , License# C—� � <br /> i . ' <br /> OTHER COMPANY <br /> Stu;�ii.3URc r.E�ssr�gso Y J N ���cuR�srsr Y!N <br /> Address M l.icense# ���� <br /> �� ' <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1}set of�neryy Forms <br /> Minimum ten(10)working days after submittal date. Required ansite,Canstructian Plans,Sanitary Faci{ities&1 dumpster <br /> C4MMERClAL Atfach(3}se#s of Building Pfans;(1)se#of Energy Forms. <br /> Minimum ten(10)working days after submittal date. Required onsite,Conslruction Plans,�Sanitary Facilities&1 dumpster <br /> All commercial requiraments must maet compiiance. ' j <br /> SiGN PERMIT Attach(2)sets af Enginesred Plans. <br /> ` *"'PROPERTY SURVEY required for al!NEW construckion. , <br /> � � i <br /> i rections: <br /> E Fili aut appiication campleteiy. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$5004) <br /> "' Agent(far the contractor)or Power af Attorney(for the owner)would be sameone with notarized letter fram owner autfiorizing same . <br /> OVER THE COUNTER PERMITTING (Front of Application.Only) ' <br /> Reroofs Sewers Service Upgrades AJC Fences(PIoUSurveylFoa#age) <br /> Driveways-Not over Counker if on public roadways..needs ROW <br /> I <br /> I - � <br /> 4 ' <br />� <br />