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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � , � � Building Depattment <br /> ::� . <br /> Date Recelved phone Contact far.Permitting . <br /> Owner's Name /� Q l,� Owner Phane lNumbe� �--,y�=_.�L�-.11 <br /> ��'1'� fi�� � Owner Phone Numbef�` � <br /> Owner"s Address �"i'"�� � - <br /> Fee Simpte Titleholder Nam Owner Phone Number�^ � <br /> Fee Simpte Tittehaider Address <br /> �oa A�n��ss a.� �Z-r�t� ,r�� �' r��s � -���� i.or� �� <br /> SUBDIVISION jpl/'���,,5 �� PARGEL 1D# <br /> _ (08TAINEQ FROM PROPERTY TAX NOTICE) <br /> WORK PRC?POSED NEW CQNSTR ADDJALT Q SfGN Q MOVE [� C7ElVl(7LISN <br /> � INSTALL ��' REPAIR . <br /> PROPQSED USE Q SFR � CON1M Q OTHER <br /> TYPE OF CONSTRUCTION [� BLOCK [� FRAME 0 STEEL Q OTHER r��-�I <br /> DESCRIPTIQN OF WORK ^'L�ZT}j�L�L �"�°'�'° <br /> BUILDtNG SIZE �_�,_� SQ FOOTAGE �� HEIGHT ��� <br /> � BUlLDING � � VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ �� AMP SEF2VICE � P�ROG�E�ENERGY [� W.R.E.C. <br /> ' ��,(, , G��� 1"(� . <br /> � PLUMBING $ <br /> C] MECHANICAL. ($ — � VALURTlON QF MECHANlCAL lNSTALLATION ' <br /> i <br /> Q GAS 0 FtOOFiNG � SPECIALTY Q OTHER , <br /> FiNISNED FLOOR ELEVATIONS (�'� � FLQOD ZONE AREA QYES QNO <br /> � <br /> BtfILDER COMPANY <br /> - �j�j5(A'('(/�� -- -- -- -- - - REGISTERED - Y/ N - FEE CURRENT_�. Y/RI. <br /> Address License# �� � <br /> ELECTRIGIAN Cf3MPdNY � ���/ �( �' �� � �z`'�`'� <br /> SIGN�0.TURE � REGISTERED Y/ N FEE CURRENT Y!N <br /> Address ��� ��'�'� �^ � �/� � License# �—`^e'�-���_,�7 ! <br /> PLUMBER Ct}MPANY <br /> SIGNATURE REGISTERED Y! N FEE CURftENT Y/N <br /> Address ticense# � I <br /> MECHANiCAL GQMPANY ' <br /> SIGNATURE REGISTERED Y/ N FEE GURRENT Y/N <br /> Address � lfcense# 1 � <br /> OTNEit COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# � � <br /> RESlDENTIAL Attach(2)Plot Plans;(2)sets of 8uilding Plans;(1}set of Energy Farms <br /> Minimum ten{14)working days afker submittaf date. Required onslte,Cons#ruction Plans,Sanitary Facitifies&1 dumpster <br /> COMMERCIAL Attach(3)sets of 8uitding Plans;(1)set of Energy Forms. <br /> M'snimum ten(14)warking days after submittal date. Required onsite,Consfruction Plans,Sanitary Facilities&4 dumpster <br /> Aii comrrierclaf requirements mast meet compliance. <br /> StGN PERMIT Attach(2}sets of Engineered Plans. _ <br /> **'*PftOPERTY SURVEY required for al!NEW const�uctian. '�� --'� <br /> Directions: , <br /> Fili out appticatian camptetely. <br /> Owner 8 Confrac#ar sign back af applicatian,notarized <br /> If over$2500,a Notice of Commencement is reguired. (A/C upgrades'over$5Q00) <br /> •* Agent{for ilie contractor)or Pawer of Aktomey(for the owne�)would be someone with notarized letter fram owner authorfz3ng same <br /> OVER 7HE COUNTER PERMiTTING (Front of Appiication Onty} <br /> Reroofs Sewers Service Upgrades AIC Driveways Fences{Plot/8urvey/Footage) <br />