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09.3-f t$U-UWI&U City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received /0 Phone Contact for Permitting <br /> ...... ..... I I Q I 13J= .................... <br /> Owner's Name Owner Phone Number 0 U <br /> Owner's Address S73,;,? Owner Phone Number <br /> Fee Simple1itleholder Name T_ Owner Phone Number <br /> Fee Simple7itleholder Address <br /> JOB ADDRESS ?7T.30- �71e,� C/ LOT III <br /> SUBDIVISION � �' FARCE.L 113#13ye Cq5-e:Ql 06 5�0_ 00000 <br /> v (OBTAINED FROM PROPERTY TAX NOTICE) <br /> 6/ <br /> WORK PROPOSED NEW CONSTRR ADDIALT SIGN DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE = SFR = COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME STEEL Q. <br /> DESCRIPTION OF WORK <br /> V <br /> BUILDINGSIZE <br /> SQ FOOTAGE HEIGHT <br /> =&.Ul LDING 1$ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL AMP SERVICE Q PROGRESS ENERGY 0 W.R.E.C., <br /> =PLUMBING 1� -� <br /> 2Z7>2, <br /> MMECHANICAL VALUATION OF MECHANICAL INSTALLATION <br /> 7�, <br /> =GAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> i i i i i i 2 l l i l l 1 1 1 1 1 N l i 1 <br /> -BUILDEF COMPANY- <br /> SIGNATURE REGISTERED I YIN . FEE CURREh <br /> Address License# F <br /> ELECTRICIAN COMPANY <br /> `SIGNATURE REGISTERED Y/ N FEECYRREIV <br /> Address License# F <br /> PLUMBER: COMPANY <br /> SIGNATURE REGISTERED 14YI N FEE CURREN DIN J <br /> A rp!ss License# <br /> Address <br /> COMPANY L_4,FL rwl.5 <br /> MECHANICAL Y / 4/ C_ <br /> ON 7 FEE,CURREh <br /> 11CAL REGISTERED <br /> SIGNATURE L C:i/ <br /> Address a 2 L License# <br /> OTHER <br /> SIGNATURE, REGISTERED Y/ N FEE CURREK LXLN_j <br /> Address License# <br /> off,fill HH"VI-4 Nis H iti is i 11..H�! <br /> HH.HH H <br /> �ets.qf Build!ng Attach 'O'W <br /> RESIDE .(2),Plot,pipris;-(2 Plans;,(I)setOf Energy Forms;R- r -Permit for newconstruction, <br /> Minimum ten"(10)�worl(in6'daysaft4§r,sdbmittal-datd. Req6ir6donsit'e.Constructon-Plans;Stonnw4te'rPlins--,W/Sllt,F6neeinst6lled, I <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsfiarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page-,(1)set of Energy Forms.R-O-W Permit for new construction. <br /> 'Minimum ten(.10)working days after submittal date.. Requited onsite,Construction Plans,ftrmwater Plans-wl Slit Fence installed, <br /> Sanitary.Facilities&I dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT 'Attach(2)sFets-of Engineered,Plans. <br /> ****PROPERTY--SURVEY required for all NEW construction. <br /> ................. ....... <br /> ---------Directions: <br /> ---- <br /> ons:6ti& <br /> Fill out application completely. <br /> Owner&Contractor sign-back of application,notarized <br /> Af-over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> Agent(fdr-the contractor).or Power of AttorneYffor the owner)would be someone with notarized letter from owner authorizing same <br /> OVEkTHE..COUNTER PERMITTING (copy of contract required) <br /> -Retobl's'lf-shingles Sewers Service Upgrades,A/C 'Fences(PlottSurvey/Footage) <br /> -Driveways-Not over Counter if on.public roadways..needs ROW -, <br />