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I <br /> � sa3-�ao-oo2o Ci4y of Zephyrhills Permit Application Fax-813-780-0021 <br /> ; • Building Department <br /> '� �3 � a - oRY <br /> Date R�ceivedi . � (7 � Phone Contact for F'ermitting <br /> Owner's Plam II 1 1( a- �U�� Owner Phone Pfumber _ �I 'O✓� ���� / <br /> � <br /> � �(�I� 2� "� /� <br /> Owner'sAddress �(.J•1o5 J IU'� �1"�Q- �� (h(��S OwnerPhone�umber <br /> Fee Simple Til leholder'Name Owner Phone fVumber <br /> Fee Simple Titleholder Address <br /> JOB ADDRESIS �CXO 5� 1� � e- I 1 ��!(�.5 �I 3 35�a �mT� �� <br /> SUBDIVISIOW P�4RCEL ID# 1 ��"`�' �� -b�fb' ��Ud� '���� <br /> (OBTAIPdED FROM PROPERTY TAX WOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT 0' SIGN Q � Q DEMOLISH <br /> INSTALL �REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE"OF COPJSTRUCTIOiV Q BLOCK • Q FRAME 0 STEEL Q <br /> DESCRIPTIOFd OF WORK �.r � �P��OU� I1.0 S U��- G ���1 O I�CIU�� (,'1�1 T(l)() <br /> BUII:DIY�G SIZE � SQ FOOT�4GE I��O HEIGHY <br /> II <br /> BUILDING $ �'1 O/` 0(� VALUATION'OF TOTAL CONSTRUCTION <br /> O( V <br /> QELEC'fRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ���o� <br /> . .� �-���� � <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATIOfV ���� �t,�yu�, <br /> i <br /> OGAII Q ROOFING Q SPECIALTY 0 OTHER � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> BUILDER COMPANY <br /> SIGMATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> i4ddress License# <br /> ELECTRICIAN COMPAPlY <br /> SIGYNi4TURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addressl License# � <br /> PLUMBER. CONVPAPJY <br /> SIGNATURE REGISTERED Y-/ N FEE CURRE� Y/N <br /> I� <br /> ; _ <br /> Address� License# <br /> flfl ECH�4RIICA[_ COiU�PAPfY <br /> SIGRfATURE!� REGISTERED Y/ N FEECURRE� Y/N <br /> , O <br /> Address� License.# <br /> a;: , � -- - -- -- - <br />- --OTHER --~� -.-� - - - -- _��/� �-- - <br /> Q N '�UOCJ� CONlF�,fVY Cl',n U(J'►"(+� �I <br /> SIGNATURE J�, REGISTERED Y I�1 FEE CU E� Y N <br /> i <br /> Address�l �p� J � � � ►� i���.S �� J�� [I License# C c 3a�5 o s <br /> ti-Ftii+H-Fii-li <br /> RESIDENTIAf_ ; Qttacfi;�,(2j;Plot<Plans;'!(2)=sets of Building�Plans;(1)set of�Energy Forms;R,O-W Permit,for new.construction, <br /> . - ,_ Minimum:ten;.(,10)working.days after'sutimittal=date. Requ(red onsite,Constniction Plans,Stormwater Plans w/Silt Fence installed, <br /> � Sanitary.;.F,.acilitie,s,&��,1�.dumpste.,r,Site�W.ork�Permit for:'sutidi"visions/large projects. <br /> CONiMERC1AL Attach(2)`complete"sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constn�ction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, � <br /> Sanitary Facilities&1 dumpster.Site,Work Permit fo��all new projects.All commercial requirements must meet compliance <br /> SIGR�PERfViI i Attach(2)sets of�.Engineered Flans.�• <br /> ****PROPERTY SURVEY required for.all.NEW.construction. <br /> Directions: I� • �� � � <br /> Fill out application completely. <br /> Owner&i�Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500) <br /> rn •Ir.. :'t i..�,. S' ,. . r „ � �. , • :, . <br /> Agent(foli th"e contracfo�)�or`Powe�'of Attorriey(for:tFi'e owner)would be someone with notarized letter from ownerauthorizing,same <br /> OVER THE COUNTER,PERMITTIPIG: �;;(copy of'aontract•required) � � ' ' ,', <br /> Reroofs if shi ii les Sewers , Service Upgrades;A/C Fences(PIoUSurvey/Footage) , ; , - -_ ,- <br /> Drivewrays-Not over Counterif ore public-�oadways::rieeds ROW <br /> �Y..-�,.-— � - - <br />