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s�aaao-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> • Building Department � <br /> Date Received Phone Contact for Permitting ��ry' ��� -- ���� <br /> Owner's Name ���i�,b �( t � -�✓1!, Owner Phone Number $�3'71 y"�}I' <br /> Owner's Address Owner Phone Number ' <br /> Fee Simple Titleholder Name I`e I���'�< <OA�t��M� ��►�. Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS SSoS y� S�. LOT# � <br /> SUBDIVISION , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED l/ , NEW CONSTR ADD7ALT 0 SIGN Q � Q DEMOLISH <br /> e INSTALL e REPAIR <br /> PROPOSED USE � SFR Q COMM 0 OTHER <br /> TYPE OF CON$TRUCTION Q BLOCK • [✓�' FRAME 0 STEEL Q <br /> .. � <br /> DESCRIPTION OF WORK V�I� �G� �a�'1� <br /> BUILDING SIZE 3�S�X G�� SQ FOOTAGE�. HEIGHT �� <br /> �UILDING $ )a S�dOn VALUATIOtV`OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP.SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> ��/� /Fe/LeGf> <br />' QPLUMBING $ � ��. <br />� �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> � ��� <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER I'.( � COMPANY Reli�•��t ,(a���,ttf7� � �L <br /> SIGNATURE �J REGISTERED Y/ N FEE CURRE� Y/N <br /> address PD �o�c �752 7-ti:!!S �C. 3353g License# C 3C �a 5 I$d1� <br /> i ELECTRICIAN � COMPANY /' � /'jG <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address IJa � License# rC� J0��3� <br /> PLUMBER., , COMPANY• S � /'C� !�(.LUYI [ NG � <br /> SIGNATURE � REGISTERED Y-/ N FEE CURRE� Y/N <br /> , Address � �Lv D y �'�L�`( icense# 4 �.2 � <br /> MECHANICAL COMPANY 'n��� 5 v/S�G/'• U <br /> SIGNATURE� / REGISTERED Y/ N FEE CURRE� Y/N <br /> Add�ess . - �UG�/ s�� �'J�9� �J License.# , 7� ��f��U� <br /> OTHER� - ' COMPAIdY <br /> SIGNA7'URE .• =� - - REcisTeReo Y/.N FEE CURRE� . Y/N <br /> Address � - License# <br /> •RESIDENTIAL�• AttacFi(2);PIot=Flans;(2)-sets of�Building�Plans;(1)�set of Energy For'ms;R-O-W Permit for new construction, <br /> _ • , � :Minimum:ten:(10)working`days after subinittal-'date. Required onsite,Con'striiction Plans,Stormwater Plans w/Silt Fence installed, <br /> , Sanitary,Facilities.&r,1�.dumpster,Site:Work Pertnitfor_sutidivisionsAarge.projects - � <br /> COMMERCIAL Attach(2)�complete'sets of Building Plans plus a Life Safery Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> , Minimum ten(10)working days after submittal date. Required onsite,Constn�ction Plans,,Stormwater P.lans w/,Silt Fence installed, <br /> Sanitary Facili6es 8 1 dumpster.Site VVork Permit fo�all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of,Engineered Plans. � <br /> ""PROPERTY SURVEY required foc all,NEW construction. <br /> I Dlrections: . _ . i <br /> Fill out application completely. <br /> O.wner&Contractor sign back of.application,notarized <br /> If over$2500,a Notice of Commencement is required. (A1C upgrades over$7500) � . <br /> '" P�qent(forthe-contractor)or Power of'Attomey(for'the owner)would be someone with notarized letter from owner authorizing same <br /> ,OVER THE�COUNTER PERMITTING . (copy of contract-_required) <br /> �......-._v..,_�.,..,,..._:... <br /> Re�oofs if shingles Sewers ;Service Upgrades .NC�, Fences(Plot/Survey/Footage) . <br /> 4 . .. , � ���:,.,.:�:,�<<.,: ��, .. �-. <br /> Drlveways-Not over Counter;if on public roaiJways..needs•�R01N <br />�I '' . .,, . , <br /> .,� <br />