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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 � <br /> Building Departrnent <br /> Date Recelved Z � � �� _ ��'I� <br /> � Y ° Phone•ContacYfor•Permlttln ' <br /> Owner's Name l �qr G� ��� VG. Jc�i,��� OwnerPhone Number <br /> Owner's Address 7 � C�"l h�� �-�� Owner Phone Number <br /> Fee Slmple Tltleholder Name ' Owner Phone Number <br /> Fee Simple Titleholder Addresa - <br /> JOB ADDRESS J �I �i'('P.�r, T IiQ, LOT# �� <br /> SUBDIVISION V�A I(p �1'y'(� PARCEL ID# � Q�"������ G j 7Q ' �QO 0 c1 � O/0 O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR ADD/ALT � SIGN 'Q Q DEMOLISH <br /> ••e,- INSTALL B ._ 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 t'tM a vc !'P y�C�, I o� ti•�.1a1 v,c,�I f 2 7`�/� f�c !'^'��f,�e ��s�� <br /> BUILDING SIZE � 3Q FOOTAGE�, . HEIGHT��. <br /> �UILDING $ " ..e.,. . ..� � � <br /> • G/ VALUATION..`OF�TOTAL CONSTRUCTION <br /> QELECTRICAL $ " AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ - <br /> , V <br /> OMECHANICAL $ � VALUATION OF.MECHANICAL INSTALLATION V <br /> Q�S Q ROOFING .Q SPECIALT1f Q OTHER ��� �I ��� <br /> FINISHED FLOOR ELEVATIONS FLOOD ON CJ" <br /> Z E AREA QYES. NO <br /> BUILDER � / ) / <br /> .� ���MF/WY' [�".'t�lc�fa�.✓ G.Jti/�/� ol� 7f-/� �' I <br /> SIGNATURE � REGISTERED Y/ N 'FEE CURRE� Y' N I <br /> Address ( �JO'�c Jl�hr.%t �i,,,� . � '� -Clcense# _d CC/����1�,�� � I <br /> ELECTRICIAN - ,�COMPANY' ' • � <br /> SIGNATURE � REGISTERED Y/ N F�Cutute��•� ° "�Y/N" <br /> Address , �y , ;� License#.�— <br /> PLUMBER COMPAWY •._-: •.. . . <br /> SIGNATURE' REGISTERED , Y,/..N,; :, FEE CURREA• �` ': Y/N - : <br /> Address � License# . <br /> MECHANICAL` " " COMPANY. <br /> SIGNATURE ' REGISTERED ,.' .Y./ N , FEE CURRE� Y/�N <br /> Address���-„- • ' � ' ` � � Ucense# <br /> OTHER � � ' ",COMPANY � <br /> SIGNATURE '.. � • ' � ` J ReGisTEriE� � Y/ N.._� FEe CUR�n Y/N. <br /> Address - _ � - ' � - � ` � Ucense# <br /> RESIDENTIAL:;< -Atta,cli(2),.Plot-.P-.lans;::(2)sets_of6'uildingiPlans;'(1)sefof�Energy=Fo'rms;R-0-WPermitfoinewconstrucUon, � ` <br /> - -;�:Minimumtten*(:1.0),,working;days�_afterMsubmlEtal`date:�R'equired onsite;ConstiucBon�Flans;`Stortnwater'Plans w/Siit Fence installed, <br /> � ��Sanitary Facilltles;&;1,;dumpster•,Stte�Worlc;P..ertnit for subdivision"sparge'projects '.•- .. _� ' ' <br /> COfVIMERCIAL Attach(3)-complete-sets oYBuilding Plans plus a Ufe Safety Pege;(1)set of Energy Forms.R-O-W Pertnit for new construcUon. <br /> Minimum ten(10)working days'after submlttal date. Required onsite,ConsUucBon Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary FadliBas&1 dumpster.Site Work Permit ior all new proJects..All commercfal requirements_must meet compllance � <br /> SIGN PER(NIT Attacfi"(2)"sets�of Eng,i'neer,ed-Plans:. .- � � �� � <br /> ""PROPERTY SURVEY reguired,for all,NEW constructlon. <br /> Directlon�: , .. - - � <br /> Fill out eppUcatlon completely. <br /> Owner 8 Contractor sign back of appltcaUon,notarized <br /> If over�2500,a Notice of Commencement is required. (AIC upgrades over aT500) <br /> .. �°�=-��:r�__�. � _� � <br /> /�gent(for the�contractor)or'Power of Attomey-(fo�the owner)would be someone with nota�ized letter from owner authorizing same <br /> �VER THE COUNTER.P..ERMITTING- --(Front of•Applicetion Oniy)-• -• ' �� <br /> Reroofs if shingles Sewers Servica Upgrades A/C Fences(Plot/Survey/Footage) <br /> Drivewaya-Not over Counter if on public roadways..need's ROW � � <br />