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i� <br /> �� <br /> •—r--a'��.'eo-oo2o City of Zephyrhills Permit Application _ FaX s�3aso-oo2� <br /> �, Building Departmenf . . , ' <br /> � ,+;, • � • " <br /> Date Recelveci Phone Contact for Permittin ' <br /> �.l - �-82. -' ��G.� <br /> Owner's Namo ��'"U/� �/l�d le Owner Phone Plumber ` OJ�s 7a�_ �p� <br /> , <br /> Owner's Addr�ss ����� �/�� �1r� Owner Phone Number <br /> �' <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Tl,tleholder Address " <br /> JOB ADDREiS ���b� // � - / ����f I LOT# � <br /> I . <br /> sueoivisio� L�rR�Nb /li�b/'i�o� PARCEL ID# 31� �� � L�/�l� �d�b6 �$�j <br /> i'I (08TAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPbOSED , e °NEW CONSTR� ADD/ALT Q SIGN Q Q DEMOLISH <br /> � INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK ' Q FRAME 0 STEEL Q <br /> DE3CRIPTIO�N OF WORK �� ��G� C.�i f�I/'U E��LQ� Q.J� 7 d/1J/��jC', �� � L r'tf7l� /�/p�j'-' <br /> � I <br /> �UILDING SIZE SQ FOOTAGE C� HEIGHT i <br /> � <br /> OBUI�DING $ �-�- :�.:.-:.- � � i <br /> VALUATION OF TOTAL CONSTI2UCTION I <br /> I <br /> QEL CTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPL�MBING $ � <br /> �� <br /> QMECHANICAL $ ���� VALUATION OF MECHANICAL INSTALLATION �C��U�Z.�, <br /> QGA� Q ROOFING Q SPECIALTY OTHER <br /> � �� <br /> FINISHED FL�OOR ELEVATIONS FLOOD ZONE AREA � QYES NO � � t � ; <br /> � � <br /> � <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N. - <br /> Address Ctcense# �- I <br /> I <br /> ELECTRICIAN _ COMPANY <br /> SIGNATURE � REGISTEREO Y/ N FEE CURRE� Y/N <br /> . , <br /> � Address , Llcense# ; <br /> i <br /> PLUMBER Cp{�ppNy � <br /> SIGNATl1RE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address� � License# <br /> � <br /> MECHANICAL �y����� ` COMPANY �/2�5 lM A-�C�ir}5��'/� �I�G <br /> SIGNATURE I G`"�j� �� REGIS7ERED Y�/ N FEE CURRE� Y/N " <br /> Address � � �ll� Z�IG�s ,�, License# ��-d �3-/. � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N , FEE CURRE� Y-/N. <br /> Address � � � License# <br /> � <br /> RESIDENTIAL! Attach(2):Flot Plans;(2)sets:of BuilcJing Plans;(1)sef of Energy�Fortns;R-O-W Permit for new.construction, <br /> Minimum•ten,(.10)working;days_aRer.submittal date. Required�onsite,Construction-Plans.�Stormwater'Plans w/Silt Fence installed, <br /> � � Sanitary Facilities&•1.,dumpster;�Site Work Permit for subdivisionsAarge projects � � _i <br /> COMMERCIAL Attach(3)complete sets of Buildirig Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w!Silt Fence installed, <br /> `j Sanitary Facilities 8�1 dumpster.Site Work Permlt for ail new projects.All commercial requlrements must meet compliance <br /> 51GN PERMI� Attach(2)sets of Engineered Plans.;., . � <br /> "••PROPERIY SURVEY required for all NEW construction. � <br /> .. 1Directlons: �� . � <br /> Fill out application completely. <br /> Owner B;,Contractor sign back of applicatlon,notarized ' <br /> If over 5�500,a Notice of Commencement is required. (A!C upgrades over 57500) ' <br /> " Agent(fa�r the conUactor)or Power of Attomey(for the owner)wrould be someone with notarized letter from owner authorizing same <br /> I, <br /> DVER THE COUNTER PERMITTING (Front of Applicatlon Only) <br /> Reroofs if shiigles Sewers Servlce Upgrades A/C �Fences(PIoUSurvey/Footage) <br /> Drivewagrs-Not over Counter if on public roadways..needs ROW <br /> 6 ' <br /> ! <br />