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s�3-7N o-oozo � City of Zephyrhills Permit Application FaX-8�3-7so-ooz� <br /> • Building Department <br /> �, I <br /> Date Received —l� �((G��r Phone Contact for Permitting � -- �� <br /> ' Kp3 ` s L�C ��3�� 2-� �� <br /> Owner's Nam I �G ��T I� Owner Phone Number <br /> Owner's Addr'ess , D �� U ' �� Owner Phone Number <br /> Fee Simple Til leholder Name Owner Phone Number <br /> II' <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS (�.- � J LOT# C� <br /> � � 1 <br /> SUBDIVISION PARCEL ID# `, "' ��' 1—O� `5���ooO�` � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR B ADD/ALT 0 SIGN i�. MOVE [� DEMOLISH. <br /> � INSTALL REPAIR <br /> PROPOSEDuSE 0 SFR COMM Q OTHER <br /> TYPE OF C IINSTRUCTION � BLOCK FRAME 0 STEEL � OTHER <br /> DESCRIPTION OF WORK ' 1 u' �I '�� u �l� Q CI � ��bl� i�01 c�� � �1 <br /> s��►� q �,IO1� ,/ �/ �rzs <br /> B{i16BJt�lG SIZE ��31 � I d�� SQ FOOTAGE � ��•S I r ���T `1 O]� �7�/ !`� <br /> u <br /> ii <br /> „ �G $j� �� VALUATION OF TOTAL CONSTRUCTION <br /> 'l <br /> [� EL�ECTRICAL $ ,,1 r�� AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> 7 � <br /> � PLUMBING $ �,��v � �i�� <br /> N ���� �``"` , <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � ,�pD� <br /> /U � <br /> 0 ;" G�S 0 ROOFING 0 SPECIALTY � OTHER � 3 p"" P �/ <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES �NO /��/�� � <br /> N ' �� <br /> SI-Bttftl7EFt' dl � —��� � ► COMPANY �I� I GN � N��� �-1"�C <br /> SIGNATURE ` �iEGISTERED Y/ N FEE CURRENT Y/N <br /> � `�5 ��A��e_ G� -�W`f ST�2�G••Jiz- I 335y License# � <br /> Address V <br /> ELECTRICI�AN V` COMPANY 'P+� SI � oI- �1 I .���� <br /> SIGNATURE � REGISTERED Y/ N FEE RRENT Y/N �L1ULy <br /> R �O <br /> Addre�s � '� j '�y �,15� ' �,� 1'+�� �J�S License# � ��� <br /> �tc� � <br /> �r�q � / � � <br /> �SER�j COMPANY ./,� �n � eCrvl �" <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Addre�ss 7 Li ,3�� License# �Cj 3 ��3D � <br /> R <br /> MECHANICAL COMPANY <br /> n <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Addrelss License# <br /> OTHER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address • License# <br /> RESIDEN IIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> II 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 for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safery Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> II Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> I� Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PE�MIT Attach(2)sets of Engineered Plans. <br /> *"*PROPERTY SURVEY required for all NEW construction. <br /> Directions�': " '"-=� � - •� ..- . . <br /> Fill out application completely. •�'' '�'�-`'� �,. • � <br /> Owner&Contractor sign back of application;'nota'rizedl � s •. � � -'. �` �-- _• --� _ _ _ <br /> If over$2500,a Notice of Commencement is�required.;{A/C;upgrades over$5000) ;' - '�"', ' "-'�'= :%`•' <br /> " Agent(for the contractor)o��Powe�bf•Attorney(for the-owner)would be someone with notarized letter from owner�authorizing,sa',me: ' • <br /> �' i . � <br /> OVER THE COUNTER PERMITTING (Front of Application Only) '�--•-•�--•�.-,,�....,,.,.�, ;�, �. ' , <br /> ReroQfs Sewers Service.Upgrades A/C Fences(PIoUSurvey/Footage) �� � ' '"""'�"'"--��-_--' <br /> '� <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> il <br /> I <br /> , p <br /> � <br />��i <br />