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s�3��so-oo2o City of Zephyrhills Permit Application Fax-813-78U-0021 <br /> • Building Department <br /> Date Received � ag"// _.--- , ��J � l�� <br /> II ��'hone Contact for Pe ' ing <br /> Owner's Na I�e / o_ O ner Phone Number d,j �i � / �� <br /> l � ,C� .��s�3 <br /> Owner's Address e • � � ner hone Number <br /> Fee Simple Yitleholder Na Owrner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRE i S - .� � / � �/ ��L ; J � LOT# � <br /> � <br /> SUBDIVISION PARCEL ID# ���� '�'�6��� � `/��' ��� <br /> I (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B , NEW CONSTR B ADD/ALT � 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 /> DESCRIPTION OF WORK .2� /C� .�� c� � i/�i <br /> � <br /> BUIL'DING S�ZE SQ FOOTAGE �a dt' HEIGHT � <br /> QBUIILDING $y/�d�)� VALUATION'OF TOTAL CONSTRUCTION <br /> 11 C/ <br /> �EL CTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br />' �PL MBING $ � <br /> � .' � <br /> �-- J� <br /> �M CHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � <br /> �G�S Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED F�OOR ELEVATIONS FLOOD ZONE AREA QYES N• <br /> BUILDER COMPANY C' 7 � <br /> SIGNATURE J REGISTERED Y N . FEE CURRE� Y/N <br /> Address License# <br /> • ELECYRI.CI� COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres License# 9 <br /> PLUMBER., COMPANY <br /> SIGNATURE REGISTERED Y-/ N FEE CURRE� Y/N <br /> Addres� License# I <br /> MECHANIC� ' COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� �Y/N <br /> Address � License.# <br /> . ;�.: , <br /> OTHER• �'' ' COMPANY � <br /> SIGNATURE F,-:= . - REGISTERED Y/.N FEE CURRE� Y/N <br /> Ad�dress�. /�'1. ' .Z4.'�(/„��✓i�r/ � � l/ License# C�iGG� ' ,7�'�`, <br /> � RESIDENTIA�_, Attach.(2),Plot P.lans;(2)'sets of•Building-Plans;(1)`set`of•Energy Fomis;R-,O-W.Permit for new.construction, <br /> :• F " �k- - Minimum.ten;(:10)inrorking.days after,subrriittal�date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> � �� �� Sanitary;F.acilities�.&�.1�dumpste[;Site:Work'Permit for=:sutidivisions/large projects <br /> �.COMMERCI� Attach`(2)complete"sets`of Buildirig Plans plus a Life 3afety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> „ ' Minimum.ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> - Sanitary Facilities&9 dumpster..Site Work Permit fo�all new projects.All commercial requirements must meet compliance <br /> "SIGN�PERMI� Attacli(2)sets of'Engineered P.lans. . . - <br /> II *"**PROPERTY SURVEY required for.all.NEW construction. <br /> :Directions: ,- ,:=�. _. <br /> Fill out alpplication completely.'` <br /> Owner&��Contractoc sign back of application,notarized <br /> � If over$2500,a Notice of Commencement is re uired. AIC u rades over 7500 <br /> q � P9 $ ) <br /> `" Agent(fij-the cont�actor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same , <br /> I <br /> .OVER�THE COUNTER;PERMITTING. (copy of contract-required) <br /> Reroofs if shirjl les Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Drivewal s-Not over Counter if on public roadways..needs_.R01N: ,. _ <br /> _4.'�:. .._'.'... ' <br /> t'" _�.::J'. .'{.-::[1��..�... � a�� _ .71� :f <br /> ` l� �..�-1�:.�.'��.�i�V.,.. ��f:i.. �. ..� � :j} <br /> �II ,� . ..._. ��r� . �:.i(ii..111.1i1`� r`ll:�n,.� , _' ,. <br /> ; ;�..� „ .1'ii��' � ... - - ,,.t. ' <br /> '- II _ ' _ �.. .._ --,. < � _..._.r� . , . .�..., . . , <br />