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41 V v4GV City of Zephyrhills Permit Application Fax-613-780-0021 <br /> Building Department <br /> Date Receivedr�.d9 <br /> Phone Contact for permitting -- <br /> -I I F-r-I-r I-r- .ems �y <br /> Owner's Name i �� t <s ,-+ �= Owner Phone Number r�"� �) L� <br /> v5�e.�o�. L'+� E.' G'_C3 trS^+ rt• :�' O o 2- <br /> Owner s Address T�n^E��J 5 5vow, ner Phone Number <br /> Fee Simple Titleholder.Name �. --� Owner Phone Number <br /> Fee Simple Titleholder Address tt <br /> JOB ADDRESS • �Zo q cZ-V a 1. I i <br /> a LOT# <br /> SUBDIVISION �' eAC_� PARCEL ID# VC)` - O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) ' <br /> WORK PROPOSED NEW CONSTR <br /> INSTALL, R ADD/ALT C� SIGN [� DEMOLISH ; <br /> • REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION , [_Q%''' BLOCK FRAME STEEL 0 <br /> DESCRIPTION OF WORK <br /> BOILIDING SIZE F SQ FOOTAGE���q C-L- HEIGHT <br /> �-e-r-r-rr��-r-o-o-nr-rr�rr-e-�-e-rrnrrrrr-rs-i-rrY-rrrr�-�-nml-v--¢^rrr-rnrare-r-rrra-a-e-�-r-m <br /> BUILDING $ i O� VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $. AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ p VALUATION OF MECHANICAL INSTALLATION <br /> t oo <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> • ' 12 2._v <br /> «�-l-➢-I-a-•i-�--➢-a-[-�-}-1•-�•••➢-�-�'•-I-G-•a-1F-�-i-r'-dr-€-➢-I-:-➢-;-I•-➢-`ri-➢-ria�f:-i•.$�.�-➢,-$-Q-1�-➢�.�*-➢�'-;•oE�-°�"a-,'1-Q�-I•-G-t«�- <br /> BUILDER f � ;,! COMPANY ° - '� - " �'� TJ` <br /> SIGNATURE Ca.� REGISTERED Y( N FEE CURREN�r� Y(N <br /> Address / ' l rr� f^ 1�r�� License# <br /> ELECTRICIA(dc. COMPANY , <br /> SIGNATURE REGISTERED Y( N FEE CURR�EN Y/N <br /> Address 6� - `t':��= P�O °" � 'J <r� License# (_ � <br /> PLUMBER COMPANY <br /> .SIGNATURE REGISTERED Y/ N FEE CURRER Y(N <br /> Address' , f � License# I a!r''C 0 1///121�2 (' <br /> MECHANICAL COMPANYf�` <br /> SIGNAI'GRE EGISTERED Y/i N FEE CURRER Y(N <br /> �. <br /> Address r) <br /> '�� f A-^" �' �'`��',^" ,�"'"� ��'a""'tr.?e�<'tr��.1`a��'�` License# CAC-0 3 <br /> ;, rrJ <br /> OTHER ' -> COMPANY <br /> SIGNATURE / REGISTERED Y/ N FEE GURREft Y/N <br /> Address - License# �^ <br /> 1liI11111' 1llilitl = liiiitilltiiiti1111Ii ➢ iIiI11I1IlI .1lI11• Il101l11IIl ➢ I.1 <br /> RESIDENTIAL Attach (2) Plot Plaroo; (2)sets of Building Plans; (1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)v:,urking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w(Silt,Fence installed, <br /> Sanitary Facilities R. 1 dumpster;Site Work'Permit for subdivisions/large projects <br /> COMMERCIAL Attach.(2)complet(. refs of Building Plans plus a Life Safety Page;(1)set of Energy Forms. R-O-W Permit for new-construction. <br /> Minimm ten (10) )rking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities r..1 dumpster.Site Work Permit for all new projects,All commercial requirements must meet compliance <br /> SiGN PERMIT Attach (2)sets of E:igineered Plans. <br /> t"*PROPERTY'SI.iRVEY required for all NEW construction. <br /> .3.-1..6-d--0-d-8-1-➢-f.�-{..Il..➢,.➢-1_0-r- -L..G-I..➢-I-➢-➢--O--Il-➢-R..b..L-.I-3-t'--&-1-➢-0..�..�-.0-#-11 3--0..➢.-0..>�.G.6..i..➢-d�A_0�§-8.a 5.4-0_4.4-8-8_ <br /> Directions: <br /> Fill out application completely. <br /> Owner�Contractor sign back of i 3plication,notarized <br /> If over$2500,a Notice of Comn_eincemerit is required. (A/C upgrades over$7500) <br /> ** Agent(for the'contractor)or Powur of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) ,...,_ _.-•:_::_;-.,:.:r_.:. ;:_•,._.....:; <br /> Reroofs•if shingles - Sewers ')ervice Upgrades A/C Fences (Plot/Survey/Footage) " •_- <br /> Driveways-Not over Counter if on?ublic roadways..needs ROW ti• <br />