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s�saso-oozo City of Zephyrhills Permit Application Fax-81& oz� <br /> . <br /> � , Building Department � <br /> Date Received �j [��� <br /> �`�� Phone Contact for Permlttin — �UCJ(J <br /> Owner's Name � 'f � �I�11 fGr Own one Numbe �,�`�� <br /> Owner's Address � � Q�+.►3.-�eV 1 ��. Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �U�1 V[A.W{G7C W � �h�11S ,�� 3�ya LOT# � <br /> SUBDIVISION �C��-J� �W PARCEL ID# Z'2��Z���2�JC�'G(�(�)UV�GO�JD I <br /> (OBTAINED FROM PROPERTY TAX NOTIGE) �II <br /> WORK PROPOSED e NEW CONSTR� ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q I <br /> DESCRIPTION OF WORK ���� ��J� / �� �fi SYS�m �r K!l •""G <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 /> I Y.IPLUMBING $ I„ �D �`�3� \ /L!� // �yti�Cl�� <br /> �rtz� � G �� �� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> / <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER /� C I� _ � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO !� %�"jt% ��/� <br /> lJ <br /> . <br /> BUILDER , - l � COMPANY ��II,W � �I/l�`�� <br /> SIGNATURE REGISTERED Y N FEE CURRE� Y/N ` <br /> Address C/ W y �0� ��3 License# `��+ISG�� ` ` '� <br /> ELECTRICIAN COMPANY � �� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER 6 COMPANY (l.W TJ�V'� L� <br /> SIGNATURE REGISTERED N FEECURRE� Y!N <br /> Address W(�[�.A G� � �) License# �ilS���L� <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIt111I11I1111i1I111t11111t11111II111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construclion, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed; <br /> Sanitary Facilities&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 Forms.R-O-W Pertnit 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&1 dumpster.Site Work Permit for all new projects.Ail commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEV✓construction. <br /> Directions:• <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over E2500,a Notice of Commencement 1s requlred. (A/C upgrades over$7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> I Reroofs if shingles Sewers Service Upgrades AIC Fences(PlotlSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW ( <br />