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ai3aso-ooso City of Zephyrhills Permit Application fiax 813-TSd-0021 <br /> � Buitding Departrnent <br /> r <br /> Date Reaeived Phone Contact for Perm(ttln � � — 7 � <br /> Owner's Name � 1^l� � Owner Phone Number X,7 �c�,�c�� <br /> Owner's Addrass T c.. Owner Phone Number � � <br /> Fee Simple 7iNehotder Name �� ! � Owner Phone Number � � <br /> Fee Slmple Titleholder Address <br /> JOB ADDRESS �L' L07# � <br /> SUBDIVlS{ON �_����� PARCE�!D# 1f�✓ i�V t1 � <br /> (OBTAlNED FROM PROPERTY TAX NQTICE) <br /> WORK PRdPOSED � e NEW CONSTR 8' ADD/ALT � SIGN Q DEMOLISH <br /> iNSTALL REPAIR �.;�' <br /> PROPOSEp USE Q ' SFR �] COMM' [(� OTHER �_��r � ���i'1�1. <br /> TYPE OF CQN$TRUCTION � BLOCK " Q FRAME � STEEL Q �i__,��_,,,_� ��v � <br /> DESCRIPTIOH OF WORK G�`1't.,. ! Q /C <br /> BUILDING SIZE � � SQ PQOTAGE C� HEIGHT <br /> QBUILDING �` Vi�t.UATiON OF TOTAL CONSTRUCTiON <br /> ,�_�� <br /> [�El,ECTRICAL �� AMP SERVICE �J PROGRESS ENERGY Q W.R.E.G. <br /> OPLUMBING �� <br /> MECHANICAI $ /�') VALUATION OF MECHANICAL INSTAI.LATION <br /> ��`��'; <br /> �GAS Q RQOFING Q SPEC�ALTY � OTHER <br /> FIM1I�SHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO <br /> BUILD�R CCIRAP�NY <br /> $IGNATURE REGISTERED Y/ N FEe CUtt�� Y/N <br /> Address ticense# � � � <br /> ELECTRICIAN GOMPANY , <br /> SIGNA7URE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Cicense# � �i`� <br /> PLUMBER I � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �� � <br /> MECHANICAL COMPANY - i^ '� � CL i°'f <br /> StGNATUR� REGISTERED N FEE CURRE� N <br /> Address �+.� � /�a..c�f �� ,!%/ L3 J�t��+.� License# 1 I��, t� ,�J��.���� <br /> QTHER COMPANY <br /> SiGNATURE REG�STERED Y/ N �E CUw�En Y/N <br /> Addreas License# � ��� <br /> RESIDENTIAL' -Attach(2)Rlot P.lans;(2)sets of Building'Plans;(1)sef af Energy°Fartns;R-O-W Pertnit for new construction, <br /> Minimum ten(10}working days after..submittal date. ftequired onsite,Construotion Plans,Stormwater P1ans wJ Sitt Fence instalied, <br /> $anikary Faci!(ties.&1.dumpster,Site Work�Permit for subd{vi'stonsllarcJe pro�ects <br /> COMMERCIAL Attach(3)oamplete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R O-W Permit for new construction. <br /> Minimum ten(10j working days after submittai date. Required onsite,ConsUucUon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Stte Work Permit for aif new profects.Alt cammetclat requirements must mest compltance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans.,, <br /> *"'PROPERTY SURVEY required for al�NEW construcUon. <br /> Direatlons: <br /> Fill aut applicatlon completely. <br /> Owner 8 Contractor slgn baak of applica8on,notarized <br /> If over�,250Q,a Notice of Commencement is required. {AtC upgrades over�,7540) <br /> " Agent(for the contra�tor)or Power of Attomey(for the awner)would be someone with notarized tetter from owner autharizing same <br /> OVER TNE COUNTER.PERMI'f'i1NG (Front of AppBcation Only) - - � •t . , <br /> Reroafs if shingles Sewers Service Upgrades A/C�� �Fences,(Plot/Survey/Footage) --� •�-' � . , <br /> Rrlveways-IVot over Gounter if an publio ioadwa}rs.:needs'ROW=°: ,,� ,.• � . 1 , <br /> .. „ .,, • _ - : , ,. ' . <br />