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� <br /> s��-�so-oozo City of Zephyrhills Permit Application Fax 813-780-0021 <br /> � Building Department <br /> I ,. <br /> Date Recelved �l 3 `��, ' �� �� <br /> i; Phone�Contact for Perm(tting <br /> Owner's Naml ���E�E �l e Owner Phone Number �����7��' <br /> Owner's Addrass � � �, l� Owrner Phone Number <br /> Fee Slmple Tltleholder Name Owner Phone Number � <br /> � <br /> i+ <br /> Fee Simple T(tleholder Address �' <br /> , <br /> JOB ADDRESS � f'' �i j � . - LOT# � <br /> SUBDIVISIO� ,LV`� PARCEL ID# D3'�o�0���! �✓`"v�Q�d � � <br /> � (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED , e •NEW CONSTR� ADD/ALT Q SIGN Q Q DEMOLISH <br /> II INSTALL REPAIR <br /> PROPOSED:USE Q SFR [!] COMM Q OTHER . <br /> TYPE OF CONSTRUCTION Q �BLOCK ' Q FRAME Q STEEL Q <br /> DE3CRIPTIOW OF WORK ��j� �� ((r/� e-Q '7' � b� ��� �C l � D �/V <br /> I <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING S VALUATION`OF�TOTAL CONSTRUCTION <br /> QEL�CTRICAL $ AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> I , o 0 <br /> QPL�MBING $ / ��I q <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> � ��.��. o� � <br /> OGAI3 Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FL i OR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE ' REGISTERED Y J N FEE CURRE� Y J N <br /> Address � License# <br /> PLUMBER COMPANY <br /> SIGNATI�RE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL' ��,j� �-/i'l/��Ly� CONAPANY �/�'/�1QS !'b !�-/11� � d-�I'e ✓�j�� <br /> SIGNATURE � REGISTERED Y/ N FEE CURREP Y/N <br /> Address �'7�T / �1//enl � J1.1.$ License# L..�/4�� c�9�� <br /> OTHER COMPANY <br /> SIGNATURE �REGISTERED Y/ N . FEE CURRE� . Y-G N, . <br /> Addres�� - License# � <br /> d <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets.of Building'Plans;(1)sef of Energy�Fortns;R-O-W P,ermlt for new conshuction, <br /> �'' Minimum;ten(:10}working:days�aftertsubmtttal date. Required�onsite,Construction Plansr Stormwater Plans w/Silt Fence installed, <br /> �� Sanitary FaGlities.&:-1.,dumpster,�Site Work�Permit for su6divislonsAarge projects � . � � <br /> CORAMERCI�,�L Attach(3)complete sets of Bullding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constru�tion. <br /> '' Minimum ten(10)working days'after submittal date. Required onsite,Construc8on Plans,.Stortnwater Plans w/Silt Fence installed, <br /> [, Santtary FaciliUes&1 dumpster.Site Work Pertnit for all,new projects.All commercial.requlrements must meet compliance <br /> SIGN PERMI� Attacfi(2)�sets ofEngineered.Rlans.,., �e��� � . j <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Ffll out a�pplicaUon completely. <br /> Owner B�+ConUactor sign back of applicaUon,notarized <br /> If over SI2500,a Notice of Commencement is required. (AIC upgrades over b7500) <br /> " Agent(filr the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER PERMITTING (Front of Application Oniy) <br /> Reroofs if shingles Sewers Service Upgrades A/C `Fences(PIoUSurvey/Footage) <br /> Drivewaly�-Not over Counter if on public roadways..needs ROW <br />