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a��-�so-oozo City of Zephyrhills Permit Application Fax-81378Q0021
<br /> Building Department
<br /> DateReceived / - 3- � Q� • 8'�3 Rg��
<br /> � Phone ConWct for Pertnitting
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<br /> Owners Name C t)W�h S t �V C��S� OwnerPhone Number ��3-3��1 -��O/
<br /> OwnersAddress J 0 ��7 /�o ✓� ' �e-/�� �����5 OwnerPhoneNumber
<br /> Fee Simple TiUeholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOBADDRESS 3g�aZ7 �.r�VQi Z�- �'l d'�1���5 �L. 335 � LOT# �
<br /> SUBDIVISION PARCEL IDIF �L�-°Z�O-°Z'��D l�I� ��19 D�- D�D
<br /> (OBTAINED FROM PROPERTYTAX NOTICE)
<br /> WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN Q MOVE Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q COMM Q OTHER �N �Gt S q,
<br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL Q OTHER
<br /> DESCRIPTION OF WORK �r �1 W���ei V 1 1'1 � �d`1 1��( `�-�.li►G Q- �/�St�II r x �(��
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
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<br /> Q BUILDING y $ � ,� �.�a VALUATION OF TOTAL CONSTRUCTION
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<br /> Q ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. -
<br /> Q PLUMBING $
<br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> Q GAS Q ROOFING Q SPECIALIY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES QNO
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<br /> BUILDER COMPANY
<br /> SIGNATURE rtEcis�Reo Y/N FEE CURRENT Y/N
<br /> Address License#
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE ��isiEReD Y/N FEE CURRENT Y/N
<br /> Address • License#
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGISTERED Y!N FEE CURRENT Y/N
<br /> Address License#
<br /> MECHANICAL COMPANY
<br /> SIGNATURE REGISTERED Y/N FEE CURRENT Y/N
<br /> Address License#
<br /> OTHER � COMPANY �� G Q����!/l C� -�N C ,
<br /> SIGNATURE � REGI57EREO Y/N FEE CURRENT Y/N
<br /> Address r� ��O�Av� D r, eJ esf e C�'1 �- 33S�f S License# �z 3� 0
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<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns
<br /> Minimum ten(10)worlting days after submittal date. Required onsite,ConsVuction Plans,Sanitary Facilities 81 dumpster
<br /> COMMERCIAL Attach(3)sets of Buiiding Plans;(1)set of Energy Fortns.
<br /> Minimum ten(10)working days after submirial date. Required onsite,ConsUuction Plans,Sanitary Facilities&1 dumpster
<br /> All commercial requirements must meet compliance.
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans.
<br /> ""PROPERTY SURVEY required for all NEW construdion.
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<br /> Directions: -'-"'
<br /> Fill out application campletely.
<br /> Owner&Contractor sign back of application,notarized
<br /> If over Sz500,a Notice of Commencement is required. (A1C upgrades over 55000)
<br /> " Agent(for the contractor)or Power of Attomey(for the owner)woutd be someane with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITfING (Front ofApplica6on Only)
<br /> Reroofs Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> DrivewaysNot over Caunter if on public roadways..needs ROW
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