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613-780-ouzo City of Zephyrhills Permit Application <br /> Building Department <br /> Date Received h g". Phone-ContacVfor'Permltting :' 6 f <br /> Owner's Name <br /> Owner Phone Number rrq25� - gtoo <br /> -1 I L <br /> OWneesAddress 4561 C.`,h Owner'Phon®Number <br /> Fee Simple'Titleholder Nam®. • Owner"Phone Number,, <br /> Fee Simple Titleholder Address <br /> � <br /> JOB ADDRESS 3 l�V 1 �Z l i��l m I� r LOT# <br /> SUB41V1$I614 PARCEL ID#: <br /> (OBTAINED-FROM PROPERTY.TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR'. ADD/ALT ] SIGN 0 [� DEMOLISH <br /> i . - INSTALL : :REPAIR <br /> PROPOSED.-USE. SFR -'0: .-COMM OTHER ' <br /> TYPtOF CONSTR(iCTION BLOCK 0 '`FRAME Q. " STEEL .0.. <br /> DESCRIPTION'OF WORK <br /> BUILDIWG}SIZE . ' SO,170 AGE .',HEIGHT <br /> =BUILDING $ VALUATION'OF TOTAL CONSTRUCTION ," <br /> =.ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING. $ - <br /> MECHANICAL $ 00 VALUATIdN OF MECHAN16AL.INSTALLATION <br /> =;GAS �]. ROOFING 0 SPECIALTY = OTHER.. <br /> FINISHED`FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> . <br /> :BUILDER! COMPANY <br /> SIGNATURE REGISTERED FEE:CURREn LYLN,J. <br /> Addr®ss License,#' <br /> 'ELEC,TRICIA.N COMPANY <br /> 'SIGNATURE REGISTERED Y/ N I FEE CURRER .Y/N.j <br /> Address License#. <br /> f <br /> P.LUMBEI 'COMPANY': - r <br /> SIGNATURE ` REGISTERED _ Y/:N:::' FEECURRE�;. <br /> ••- <br /> Addrfiss. License#; <br /> . :.AAECHAiVICAI' .C,O�IAAPANY ,l � .�.RG , <br /> SIGNATURE— 'REGISTERED REGISTERED /N FEE CURREh .: Y./N t: <br /> AdaPe$ss>y: 3:: 1 ` i (ti,I I S L = .License.#^l..r�v t$ .8 9� . <br /> - <br /> 'i: <br /> �.;;;_ - <br /> ::$IGNi4Yl'iI�E°Y; REGISTERED Y/.N FEE Cl7RREK Y/N <br /> L'fcense`# . <br /> - _ <br /> - - - �- <br /> :RESIDENrTiIAI :_ ;A c 2 Plot%P-aans 2' 5'ets o Buildin ^Plans 1t=set of Ene =Forms 'R 0=1N Per[n1t rri'"fir:{ nstu tIo <br /> sMlrllmu ten '10.,wo''iii da":after:' `'birr ttald`ate:'sk�e uired:pnsife Contraction Plaes'Stomnwater'Plens w/S(ItFence.install'ed; <br /> Sama FacilitiesR&?dum ste'•;Si 'rW. dc<,P,.ermlt:foi ubdivlsio'slla: ®? io acts' °':" ';`: <br /> -, <br /> eCOH�MERCIAL Attach 2 cum lets s'ets7of"Buildin` Plans` ills a Life'Safe Pa e; 1 set of Ener Forms.R-O-W Permit for'neviw 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 4IImew`projects.All commercial requirements must meet compliance ' <br /> `;SIGtV`P RIVIIT -Attd-I;Tsets;o#) =gin®eredPlans <br /> , <br /> ""PROPERTY SURVEY requirgCfor,all,NEW._,.onstructlon._.. <br /> ------------------------ <br /> Fill'out application.completely. <br /> Owner.&Cantyactorsigra:backofapplication,notarized <br /> ,.._ '°if;over.-$2500.a Notice;of;Commencement is required. (AIC upgrades over$7500) <br /> Agent`(f&thd-11c6h#,actoT);Ar Power=of'Attorney`(for'the"owner)Wduid"tie someone with notarized letter from owner authorizing same <br /> r Q1 ERTHE COUNYER=Pt2AAl7TltdG..._:::..(copy ofcontractrrequired) <br /> i'A ,._ <br /> •,:;,,eroofs�ifatiingles ~`Sewers .Service Upgrades A/C . . :Fences(Plot/Survey/Footage) _ <br /> DrIVeways-Not over Counter ifompublidibadways::`ne'eds'ROVV <br />