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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 ?It v t— ) <br /> Bulltling Department Lam/ <br /> r� <br /> Date Received 2 C/§Phone Contact for Permitting ( L' Vi t77 <br /> r _ <br /> «L� Owner's Name �—�� a���. 75`r ( ��� � t-L— Owner Phono Numbor 5 r <br /> Owner's Address ✓ t\1'1'-9L—= /r'j� 0/t� owner Phone Number J )a <br /> /3`1 � r2OQ ` /. u 11 <br /> 0 Fee Simple Titleholder Name I Owner Phone Number <br /> � oow a <br /> Fee Simple Titleholder Address �� c ri. Q <br /> Z.v�� <br /> JOB ADDRESS T /' �� -�� )l2 T+` LOT# per- ®�Qr n <br /> J .� <br /> SUBDIVISION r7 v-��l 1Pi ��RCEL ID# , z a �� J~ L1-'-3 L -G of U C ® pg <br /> (OBTAINED FROM PROPERTY TA.NOTICE) CA rb <br /> WORK PROPOSED NEW CONSTR ADD/ALT IGN = = DEMOLISH CO <br /> e INSTALL a REPAIR <br /> PROPOSED USE = SFR Q COMM = OTHER <br /> 'elI <br /> TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL a y <br /> DESCRIPTION OF WORK �+ W V vti ) C1 L J 14 <br /> vl VI,C—t_ i_C� s SC-r res� Lu <br /> U_ {` w <br /> BUILDING SIZE Z 3'� �� 1" 5Q FOOTAGE HEIGHT <br /> r <br /> BUILDING $ 11-.' VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $�_,�j S t_S. I AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C. <br /> =PLUMBING $ f.1 1-'r- l�_L� ' _1 �'` O 56 ! �J S �5 <br /> =MECHANICAL $ fJ�,>, VAL �t9N'OF"'MECHAN1AL INSTALLATION �� J I ��� <br /> =GAS = ROOFING Q SPECIALTYJ� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER 11 ' COMPANY 1610 L1j�z �"Jx'rlk` S. G)j'� <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN Y/N <br /> Address I License <br /> r—� <br /> ELECTRICIAN ✓I 1 } COMPANY <br /> SIGNATURE (I REGISTERED Y/ N FEE CURREN Y/N <br /> Address I License' <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREK <br /> Address License# <br /> MECHANICAL --- COMPANY <br /> SIGNATURE REGISTERED Y l N FEE CURREN YIN <br /> Address I License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEECURREK Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIII11111111111111111111111111.1111111111111.11111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building 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 subdivisionsAarge 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. Required onsite,Construction Plans,Stormviater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> —PROPERTY SURVEY required for all NEW construction. <br /> ..Directions: <br /> Fill out application completely. /3•r �L•J G �--��•)�)��• <br /> Omer&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> Agent(for the contractor)or Power of Altomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> x OVER THE COUNTER PERMITTING (copy of contract required) <br /> , `Reroofs it shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />