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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> V Building Department <br /> Date Received L Phone Contact for-Permitting- L)i <br /> Owner's Name 4. V eS Owner Phone Number <br /> Owner's Address Ig Lo Owner Phone Number- <br /> Fee Simple Thleholder-Nams' Own-or Phone Nunib6r <br /> Fee Simple Titleholder Address L <br /> JOB ADDRESS I La W coq Radien wv)ed 4. LOT 0 <br /> SUBDIVISION is- I V cya o o _PARCEL lO.I-o5- aw-aI - D -WLI DO- Q 1-10 <br /> (OBTAINED FROM PROPERTY-TAX NOTICE) <br /> WORK PROPOSED e <br /> NEW-CONSTRM- ADDIALT' SIGN'- DEMOLISH <br /> INSTALL M REPAIR <br /> PROPOSEDVSE 0SFR F-1 COM'N OTHER <br /> TYPE OF CONSTRUCTION -BLOCK Q FRAME 'STEEL <br /> r <br /> DESCRIPTION OF WORK. ...... <br /> BUILDING SIZE SQ FOOTAGE'=., HEIGHT I-, <br /> I I i I I I i 1,1113J.1 144 <br /> BUILDING $ <br /> VALUATION 00 TOTAL CC)NSTWOdti'ON <br /> =ELECTRICAL 1$ AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C. <br /> PLumsING..- <br /> DO <br /> =MECHANICAL $ VALUATION'OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> FH ki, 414,4011414 <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED LY/ N FEE cuRRF,\ <br /> Address <br /> Liconsei <br /> ELECTRICIAN,- COMPANY' <br /> SIGNATURE' REGISTERED Y/ N FEE CURREM1­ 'LjLN <br /> J. <br /> Address -License# <br /> PLUMBER COMPANY Bend t m cc <br /> Y1 N <br /> SIGNATURE, ✓ REGISTERED ZL FEE cu RRa -E15S- __ <br /> Address bay) I f-I lip, <br /> MECHANICAL <br /> COMPANY <br /> SIGNATURE <br /> REGISTERED Y I N. . FEE cURREN: <br /> Addrozii <br /> F-7 <br /> COMPA <br /> ,OTHER <br /> SIGNATURE REGISTERED 1-Y1 N-4 FEE GLIBBER <br /> Address License# <br /> HH+ <br /> .RESIDENTIAL -Attach'(2)„Pl6fPlai4is,(2)s6 (1)' dic nergy:,o s;.R W ft".7cops"Aan, <br /> Subans, LID- -PbriMitfoi <br /> Mlnlmum�.. _,(,j9)!W*ng...4ByS tfaFdati.'-Rdquifid oftIfa,-_cbhd66lIOn, -_6ni,.!SWTmwatdr?lafis 4 Sllt:Femce Installed, <br /> Sanitary for sub4Ivjqj9)nBfIai00:projdq!s�:, <br /> COMlWERCIAL Attach(3),boffiOlbfiiieti of Building Plans 016S a Life'Safity Page;(1)set of Energy Forms.- ' - R-0-W Permit for new cc n stru ctl o n.- <br /> Minimum ten(10)working days after submittal date. Required-onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all new projdats-All commercial requirements,must meet compliance <br /> SIGN PERMIT Attach(2ysiits of Ehg!6-eik'r.id':Pla_nis�.- <br /> `PR0PERTY,SURVEYNqqj*,ior <br /> aIl.NEW construction.. <br /> .............44 1 1 1 <br /> -------- ------ <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement Is required. (AfC upgrades over$7500) <br /> Agent(for thi bion"i):or Power of Attomdy(for the owner)would be someone with-notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING -,.(Front of-Application Only) <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter If-.pn public roa5ways-66eds ROW <br />