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e�s-�8o-002o City of Zephyrhills Permit Application Fax-873-780-0021 <br /> Building Departmenl <br /> � bate Recelved • - <br /> -rr-�-�-�T� Phone Gonlact tor Permhtlo _ <br /> Owner's Name � � <br /> _ �s� Owner Phone Number 7� ^� ^'7 �f�p <br /> Owner's Address ���-( � `��S Owner Phone Number <br /> Fee Slmple Titleholder Name Owner Phone Number <br /> Fee Simple Tltleholder Addresa <br /> . .____ _ <br /> . - <br /> JOB ADDRESS 3(J( Q'N`. _ �`��,$ `-�L� ,� LOT q � <br /> SUBDIVISION PARCEL IDI{ .Io�"o�p'" — (� ,- —()` <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW coN57R 8 ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PFtOPOSED USE Q� SFR Q COMM �� OTHER " <br /> TYPE OF.CONSTRUCTION Q BLOCK Q FRAME � STEEL Q ' - <br /> DESCRIPTION OF WORK � � � <br /> . <br /> I , _ <br /> . . _ <br /> . <br /> � � <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br />� r � .. , .. : . �. .'.IRV'f�IRTIT7�IT• . ... .. .ITr7TPr•rl••rrt� , <br /> 1"1"r.' <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUGTION i <br /> QELECTRICAL $ '"" ' ' AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br />' QPLUMBING' $' ' �i- �Q� <br /> p' >� �� U <br /> � <br /> �MECHANICAL $ j (�D'p� ' VALUATION OF MECHANICAL INSTALLATION �/ <br /> .T � <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER r Dl rn <br /> �y� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO 1� <br /> -�-1�-�-1�-1-F-d-�1-4�4-4.��{�p�-r�4-4-i=��f-d��.-�:�••:'•4-1-{-4-1-1-a-�1-:-T'.�.�{�-{-1--1--L-I�I:a--1�4-�4-{-i-1�''.�.� <br /> 6UILDEFi COMPANY <br /> SIGNATURE . . . . . REGISTERED .Y I N FEE CURR�� ..Y I N <br /> I . .. ' .. . . .-. .�._.. .. . <br /> Address _ License# <br /> ELECTRICIAN �COMPANY � <br /> SIGNATURE ftEGISTERED � Y I N FEE CURREA� Y/N ' <br /> Address �Icense# <br /> - . . .... ":. . . ' _ ' . <br /> PLUMBER COMPANY <br /> SIGNA'fURE REGISTERED Y/ N � FEE CURREA Y I N. <br /> Address <br /> License# �--� <br /> MECHANICAL COMP.ANY /n� I cLn J�P�✓��(„1 gS Q�-' <br />� SIGNATURE � REGIS7ERED � .Y J N FEE CURRE� Y/N <br /> Address .0 �jp' �.Q � 5 / �j . License# � �/ <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br />, Address License# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENTIAL Atlach(2)Plol Plans;(2)sets of Bullding Plans;(1)sel of Energy Forms;R-O-W Permll for new construction, <br /> Minlmum len(10)working days afler submlllal data. Requlred onsite,Construclfon Plans,'Slormwater Plens w/Silt Fence installed, <br /> Sanitary Fecllllles 8 1 duinpsler•,Site Work Permit(or subdfvislonsllarge proJecls <br /> COMMERCIAL Allach(2)complete sels of Bullding'Plens plus a Lifa Sefety Page;(1)se�of Energy Forms.R-0-W Permit tor new conslruction. <br /> Minimum len(10)working days afle�submHlal dale. Required onsile,Construclion Plaris,Slormwaler Pleris w/Sill Fence fnslalled, <br /> Sanilery Fecllilles 8 1 dumpsler Sile Work P,ermil for all new proJecls.Ail commercial requirements musl meet complfance <br />, SIGN PERMIT Allach(2)sels of Engineered Plans. ` <br /> ""PROPERiY SURVEY required(or all NEW construcllon. <br /> -�H-d-'.�...-�{:.4-1-1�-4-4:'.-.�.�-.-.+�.-.-'".-��'.-6�4:F-'".-.�'��I-d-{=7-'�.-.F+�'.'-rC�•' �..�:.�� <br />� Directlons:• <br /> Fill oul applicallon campletely <br /> ' Owner 8 Conlraclor sign beck of application,nolerized <br /> I(over$2500,a NoUce of Commencement Is requlred: (AIC upgredes over$7500) <br /> " Agent(for lhe conlraclor)or Power of Attorney(for the oviner)would be someone with nolarized lelter from owner euthorizing seme <br /> OVEFt THE COUNTER PERMITTING (copy ot conl�act required) <br /> Reroots If shfngles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) _ <br /> Driveways-Nol over Counler If on public roadways..needs ROW <br /> _ � <br />