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s1s-7so-ao2a City of Zephyrhills�Perm���}IIC�fIOtl . Fax-813-780-4d2�f <br /> Building Department <br /> Date Received 2 ,. l� "' L Phane Contact for Permitting �2M1- - Z�y - ��o <br /> Owner's Name M�c �1 '�c+ Owner Phane Number y 35 � 5 3� r to J�5 <br /> Owner's Address ��3 Oa�K Gt� Owner Phone Number�! � <br /> Fee Simpie Titiehoider Name Owner Phane Number� � <br /> Fee Simpte Titleholder Address <br /> JOB ADDRESS Csr �'}G Cy cL Y � LJ'�'• LOT# ��r <br /> ` sue��vts�aH do.lrt C.teS�- �.s�-o.�rc� �A�c���n# 02- Z{a - 21 -o23t7 -0000t7—vtocs <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPt}SED e NEW CONSTR e Dl L � SIGN Q MClVE 0 DEMpL1SN <br /> —._---- —� _ --- INSTALL _. EP -- . - __. w ._ . , <br /> PROPOSED U5E Q SFR 0 COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK � FF2AME Q STEEL Q OTHER�— -I <br /> n5 t1_''►l.4s -'�'s31r�S5 �+'+ oW Q'- Y►^`r <br /> DESCRIPiION OF WORK �.C�✓rt 0 ve, i S�r"1 n $GfCP..l�f M �nd �^5��,�� -��M �Q.SS uri�tab <br /> BU1�DiNG SIZE �_ � SQ FOOTACE C-� HEIGHT �!���� � '��' <br /> c.o nc.1'e�-�, <br /> � BUILDING $ �•-�, ��� . p�� VALUATION OF TOTAL CONSTRUCTION <br /> � ELEGi'RICA� � � AMP SERVICE � PROGRESS ENERGY CJ W.R.E.C. <br /> � PL.UM82Nf� � � ��� ,c- <br /> � MEGHANICAL $ VALUATlON OF MECHANlCAL lNSTALLATION ���� <br /> V � <br /> Q GAS Q RC70FING 0 SPEC1Al.TY [� OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA �YES �NO <br /> BUILDER ('}i����r •� � ]�' CQMPANY �-- ��C S ��. Ke�model i Y 1 <br /> SIGNA7URE /'�/� � REGISTEREp N FEE CURRENT Y I <br /> Address �S��7 �- tJ a.'�Gr 5 �'ti/G License# L,�C � <br /> ELEGTRIGIAN COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRENT Y I N <br /> Address Ltcense# �^ � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRENT Y/N <br /> Address License# �— _� <br /> MEGHANICA�. COMPANY <br /> SIGNATURE REGISTEREp Y J IV FEE CUi2RENT Y/N <br /> Address License# �— � <br /> QTHER COMPANY <br /> SIGNA7URE REG�STEREt7 Y/ IV FEE CURRENT Y J N <br /> Address License# � � <br /> RESIDENTiAI. Attach(2}Plot PEans;{2)sets of Buiiding Ptans;(1)set of Energy Forms;R-O-W Permit for new canstruckion, <br /> Minimum ten(90}working days affer submiftai dafe. Requfired onsite,Constructian Plans,Stormwa#er Plans w!Siit Fence insfatled, <br /> Sanitary Facllities&1 dumpster;Site Work Permit far subdivisions/large projects <br /> COMMERCtAL Attach{3)sets of Bultding Pians;{1}set of Energy Forms.R-O-W Permit for new constructlon_ <br /> Minimum ten(10)working tlays after submittal date. Required onsite,Construction Plans,Stormwa#er Plans w/Sitt Fenee instailed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit far all new projects.All cammercial requirements must meet campliance <br /> SIGN PERlU11T Attach(2}sets af Engineered Plans. <br /> *'""PROPERTY SURVEY required for all NEW construction. . <br /> D�rections; <br /> Fill out applicakion compietely. <br /> Owner&Contractor sign back of applicatio�,notarized <br /> If over$250Q,a Notice of Commencement is required. (AIG upgrades over$5044) <br /> *' Agent(far the contractor)or Power of Attomey(for the awner)would be someone with notarized letter from owner authorizing same <br /> �OVER TFiE COUNTER PERMtTf'IN� (Frant of Appticatton Only} ' <br /> � Reroofs"- Sewers Service Upgrades A/C Fences(PIot/SunreylFaokage) " � <br /> Driveways-iVo#over Gounter if an pubtic roadways..needs ROW <br />