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A 813-78"M City of Zephyrhills Permit Application Fax-813-70"021 <br /> Building Department <br /> Date Received Phone Contact for Permitting �3 — <br /> Ross <br /> Owner's Name /Q_t/`✓r11� V�rJ Owner Phone Number <br /> Owner's Address( —1. I o/ Af <br /> ph/� t�Qi ow Phone Numtzr <br /> Fee Simple fiiHoholder Nome. Owner Phone Number <br /> Fee Simple Titleholder Address n <br /> SOB ADDRESS t? V LOT# �� <br /> SUBDIVISION 1 /1 V/ PARCELID# s as-ai-oosw-00000- 1&16) <br /> t(BTAMW FROM PROPEM TAX ROME) <br /> WORK PROPOSED NEw c.0NsTR ADDIALT SIGN [� Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR COMM Cr�� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK = FRAME L J STEEL <br /> DESCRIPTION OF WORK t�h5�+}�t a' ic}` �Srf rt i�/r`z/Y ac u 1 Ct)1, A� CChfiu SCaaAl <br /> 13UILDING SIZE (� rX ` [ " SQ FOOTAGE / 7 IaEIGNIT <br /> ILDING S VALUATION OF TOTAL CONSTRUCTION <br /> y <br /> =ELECTRICAL Is AMP SERVICE PROGRESSENERGY = W.R.E.C. <br /> =PLUMBING Is � <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> i <br /> =GAS Q ROOFING = SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER �_(..� � �� CG{IPANY � �'''�I <br /> SIGNATURE Q r RMST- o Y/N cwM Y!N <br /> /s <br /> Address I F /,/t 1 c kfo- 'Dt Z-rrr� <br /> l V S or�[- License If Fkc/3 <br /> I <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REGSTERED YIN FEE CwtREn LXLNJ <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE ( RFC® I Y/N F'EEetnO* _Y!N <br /> Address License# <br /> MECSIGN COMNY PA <br /> SIGNATURETURE I REG}5rERED Y/N FEE CIfiiRLT Y/N <br /> Address License#F <br /> OTHER COS Y/N r�cURRer Y!N' SIGNATURE <br /> Address License# <br /> III II11 { o111IlIId611 { I / 1 { l111 { / 111111111111 / 11 { { 1III / 1 { I / II / I11 { { { 11 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Budding Plans;(1)set of Energy Forms;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 Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(2)complete sets of Budding Plans plus a Life Safety Page;(1)set of Energy Fonns.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required r nsite,Construction Plans,Storrnwater Plans w/Sift Fence installed, ; <br /> Sanitary Facilities&1 dumpstmr Site Work Permit for all naw projects.All commercial requirements must meet compliance <br /> SIGN PERMrr Attach(2)sets of Engineered Plans. <br /> "*PROPERTY SURVEY required for all NEW construction. I <br /> Directions:• j <br /> Fill out application completely. li <br /> Owner&Contractor sign back of application,notarized <br /> tf over$2500,a Notice of Commencement is required. (/VC upgrades over$7500) <br /> Agent(for the oontractor)or Power of Attorney(for the owner)would be someone(uftb notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroute if shingles Sewers Service Upgrades AIC Fences(PI-3t/Survey/Foota9e) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />