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a�a-�eo-oozo City of Zephyrhills Permit Application Fax�1&780-0021 <br /> � Building Department <br /> Date Received ^ phone Contect for Pertnitting <br /> , �1�11'1 ��" '-frU -'��S- 7 �� <br /> Owner's Name � Owner Phone Number <br /> Owner's Address 3 3 y--] .�i�L � �' � l � Owner Phone Number I� <br /> Fee Simple TiBeholder Name � Owner Phone Number <br /> Fee Simple Tideholder Address � <br /> JOB ADDRESS 3`1 3 '-� -1 I V'�U-�� �` l ��' '1 V���'S LOT# � <br /> SUBDIVISION ^ 0 `l���� PARCEL IQIt ����t� ��I � �� I� — ��Du —u �� <br /> (OBTAfNED FK018 PROPERTY TA1C NOTICE) <br /> WORK PROPOSED B NEW CONS7R� 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 Q STEEL Q <br /> DESCRIPTION OF WORK �-"C-�'�� <br /> BUILDING SIZE S4 F007AGE� HElGF{T � <br /> QBUILDING $ �f'1r•% VALUATION OF TOTAL CONSTRUCTION <br /> !i �o. <br /> QELECTRICAL $ AMP SEf2VECE Q PROGRESS ENERGY Q W.R.E.C.�` _,� <br /> yV\ <br /> QPLUMBING $ �, <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALIATION � � <br /> � ��v <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER Iv �n COMPANY <br /> SiGNASURE � � REGIS7ERED Y! N �curu�n Y!N <br /> Address License# <br /> ELECTRICIAN COMPANY � <br /> SIGNATURE �GisrEaEv Y/ N �e cuar�n Y/N <br /> Address � License# <br /> PLUMBER COMPANY <br /> SIGNATURE r�Gi5r�n Y/N �curu�n Y!N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE rx�cts�o Y/N �curu�n Y/N <br /> Address License# <br /> O7HER � COMPANY ` '�"`^�' �1�� L� <br /> SIGNATURE r�cisr�u / N �curux�n Y/N <br /> �d�� ��S� c-�re2� �� I � �"r. -j-c{ c,�, ��:-ee,�- ���se# �-cG 13 3 D 4-3 <br /> �.� � � � � � r � �:r.� r� � rrri �:�.r � rr� r� ri.�.� � � rr:� rrrc�.� � c� r-r� � � rr� r� r.rcrri �.r � r.� <br /> RESIDENTiAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;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 subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Buiiding Plans plus a Life Safely Page;(1)set of Energy Fortns.R-O-W Pertnit for new wnstruction. �i <br /> Min'imum ten(�0)working days ailer suhmilFal date. Required onsite,Construciion Plans,Startnwater Plans w1 Silt Fence instalied, I <br /> San'dary FaciliGes&1 dumpsler.Site Work Permit for all new pmjects.All commercial requiremenfs must meet compliance ' <br /> SION PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required forall NEW consVuction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over SZ500,a NoUce of Commencement is required. (A!C upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized Ietter from owner authorizing same <br /> OVER THE COUNTER PERMITrING (copy of contrac[required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage) <br /> Ddveways-Not over Counter if on public roadways..needs ROW II <br />