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8".3-780-0020 City of Zephyrhills Permit Application Fax-sly-78MO21 <br /> Building Department <br /> Date Received Phone contact for Permittin <br /> fMt�2 orita t <br /> --2 ✓ Owner Phone Number gl_q� <br /> Owner's Naine Z i-J) -1wel <br /> Owner Phone Number <br /> Owner Address <br /> r'U owner Phone Number <br /> Fee Simple Titleholder Name Name <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 1110-916- Zw;ry LOT# <br /> 0 240 <br /> SUBDIVISION PARCELID#1 0��A 0?/ OL <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ffo*%DDIALT SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK L,Q FRAME Q STEEL <br /> DESCRIPT,ONI OF WORK <br /> I0 BUILDING SIZE FOOTAGE HEIGHT <br /> . . . . . . . . . . . . . . . . . . . . . . . <br /> UILDING 1$ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL Is AMP SERVICE Q PROGRESS E NERGY Q W.R.E.C. <br /> =F'LUMBING is '2/1�( <br /> [Ker.ECHANICAL IS.6-1-1 a6—✓ VALUATION OF MECHANICAL INSTALLATION JID <br /> =C',A'S Q ROOFING Q SPECIALTY = OTHER <br /> FINISHED�-LOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> . . . . . . . . . . <br /> BUILDER I COMPANY I <br /> SIGNATURI- REGISTERED I YIN FEE CURREh <br /> Address I License <br /> ELECTRICi ON COMPANY = <br /> SIGNATURE REGISTERED I YIN I FEE CURREI, YIN <br /> Address License# <br /> PLUMBER COMPANY = <br /> SIGNATURE REGISTERED I YIN FEE CURREN <br /> Addre,.is License# <br /> MECHANICAL COMPANY <br /> z _12e <br /> SIGNATUP REGISTERED I Y/ N FEE CURREN I Y/N <br /> Address ;Zz� License# <br /> OTHER COMPANY = <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN L_KLN_j <br /> Addre3s I License# <br /> III I 1 11111 11 111 11 111 If 111 11111 111111 1 111 if III III III If If 111111 If 111 11111 <br /> RESIDENTAL Attach(2)Plot Plans;(2)sets of Building Plans:(1)set of Energy Forms;RA-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&I dumpster,Site Work Permit for subdivisionsilarge 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 ensue,Construction Plans,Stormwater 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 /> .&Dir:gits <br /> 6:igan — vu — sou . . . . . . . . . softeavaigailiffasawas . . . . . . . . . . . . . . . . . . . . <br /> Fill ou.application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement Is required. (AIC upgrades over$7500) <br /> Agent,{for t'he.contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMi4flNG­_- -(copy of contract required) <br /> Reroofs if s-ingles Sewers Se rvI <br /> 'ce Upgrades A/C,, Fences(Plot(survey/Footage) <br /> Orlvm-,ays-No't'av6r-Counter if•-on public roadwaYs.-n6eds ROW <br />