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� s�saeo-oozo City of Zephyrhills Permit Application � FaX-a�aaao-ooz�
<br /> ' � Building Department
<br /> Date Received
<br /> Phone Contact for Permitting -� _.
<br /> Owner's Name Owner Phone fVumber -
<br /> Owner's Address Q �- Owner Phone Idumber
<br /> Fee Simple Titleholder ldame Z C''. �'1 T` � $ � I Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �3 � Z � LOT# �
<br /> SUBDIVISIOW �YVI���,�� e�� pARCEL ID# L.O��
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED � e . NEW CONSTR B ADD/ALT � SIGN Q � Q DEMOLISH
<br /> IPISTALL REPi41R
<br /> PROPOSED USE Q SFR Q COMM 0 OTHER .
<br /> TYPE'OFCONSTRUCTION Q BLOCK �• Q FRAME Q STEEL Q • -
<br /> . DESCRIPTION OF WORK ��C � + � Q� '�C � �
<br /> BUILDING SIZE � ' SQ FOOTAGE I�1O S , HEIGHT •. li
<br /> �BUILDING $, �5 VALUATION'OF TOTAL CONSTRl1CTION
<br /> QEI:ECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> �•
<br /> QPLUMBING $ �
<br /> � � v
<br /> QMECHANICAL $ VALUATION OF MECHAiVICAL'INSTALLATION ��
<br /> QGAS - Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO
<br /> � .
<br /> BUILDER ' -EOMPANY • v+� � .�'
<br /> ti
<br /> SIGNATURE f REGISTERED Y/ N FEE CURR � Y/N
<br /> Address �License#
<br /> �'ELECTRICIAN � COMAPANY` - ' '
<br /> SIGNATURE REGISTERED Y/ N '� �FEE CURRE� Y/N.
<br /> ' Address : , License#
<br /> ,,., , - ,
<br /> P.LUMBER.;. , , - COMPANY- ; �
<br /> SIGNATURE REGISTERED Y.�/'N'��: _ "'.:FEECURRE�- Y/N
<br /> , Address �.:License#`-:
<br /> , �; _
<br /> - .MECHi41VICAl;' � �p�rypqNy .
<br /> I SIGNATURE', � � � REGISTERED ,' Y/-N. , :FEECURRE�' Y/N ' , -
<br />, �aaa�ess�� " uc��se.# � .
<br /> .:�£� i`' � , - . . . . , .- '
<br /> ' OTHER�� `:'::- � ' COMPAPIY
<br /> ;"SIGNATURE:i,�� -� - REGISTERED Y/ N.. FEE CURREK Y/N
<br /> z-�, �'�, ti . - . ,
<br /> Address��•. = _ �•�->• - = � � Cicerise#
<br /> ' s, r �5,: . �� _
<br /> �;�RESIDENTIAI.�.�,;. `,i4ttach�;(2)�PIof�Plans;t(2)�sefs�of Building�'Plans;(1�)`set of�Energy_Forms;�R;O-W Permitfor new.construction, .
<br /> �_� ��> • •�- Minimum;ten;(10),working;days'afte�submiltal�date.�Required`onsite;Gonstr'uction Plans,°$tormwater Plans w/Silt Fence,installed,
<br /> `:.. , ";",F:a:�.r��`.,,"'..:,.„�.,.,,.... .
<br /> �. ,., " Sanitary�FacilitiesA&r1,,dumpster;_Site�;,.W.or,k'Recmitfor!subdi.visionsHarge'p�ojecfs'= �-, " - '
<br /> �,r:COMMERGIAL AttacFr(2f'complete sets of`Building'Plans�plus'a�Life Safery Page;(1)set of Energy Fortns.R-O-W Permit for new construction.
<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 1Nork Pe.rmit foF-all�new piojects.All commercial requirements must meet compliance
<br /> .�,..:. .. .
<br /> .:-SIGN;PERMIT "Aftach(2)sets.qf;Engineered�Plans:��: �� , . � -
<br />' *"*PROPERTY SURVEY,required for..all.,NEW.constructlon.. _ _
<br /> `,';„Di�ections: . 'zrYa _ ,
<br />� • ' �Fill:out'a lication com letell,.
<br /> PP P Y�`
<br /> - -'O.wn r:��
<br />� - e ConVactor sign back of application,notarized .
<br /> - �f .
<br /> i over• 2300 a Notice of Comme e en i r r
<br /> nc m t s e ui ed. AIC u ra v
<br /> _ $ . q ( pg des o er$7500) _ . _�
<br /> „.e�.- ...r`:,srt� _ _ _ . .,_. _ . -
<br /> ��i,. - _ - _ _ _
<br /> A' e �for' , -
<br /> _ ,g nt( tlie�contractor)�or�Power of;Attomey(for'ttie owne�)..would tie someone with notarized letter from owne�authorizing same, _
<br /> rt^�OVER:THE COUNTER�PERMITTING. � (copy_of-contract--required)� � � . { , ' ,�` '
<br /> ±�'�Reroofs:if:sfiingles T - Sewers �� Service Upgrades A/C: Fences'(PIot/Survey/Footage) ;. � :_ `
<br /> ` Driveways-Not over Counter.if on public roadwaFys..needs`ROW��� �- --
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