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i <br /> I <br /> 1113-7e0.0O20 City of Zephyrhills Permi Application Fax-813.78043921 <br /> Building CaPefte It <br /> Date Received Phone Contact for Permittin <br /> 9wnePa Name ►�• - - j <br /> r Phone Number <br /> Owners Address tuner Phone Number <br /> Fee Simple Titleholder Name Owner Phono Number <br /> Fee SlmPle Titleholder Address <br /> JOB ADDRESS W ( LOT# <br /> SUSDIVISION J dtao I PARCELIDN <br /> (oaTnitrfib FROM vaovERTrTIur Nancls) <br /> WORK PROPOSED El INSTALL <br /> CONSTR® ADD/ALT SIGN = Q DEMOUSH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION © BLOCK 0 FRAME STEEL <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE �a SRFOOTAGB ME1014T <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL S AMP SERVICE = PROGRESS FNERGY = W.R.E.C. <br /> PLUMBING S O f � w% <br /> 6. <br /> =MECHANICAL $ VALUATION OF MECH WICAL INSTALLATION <br /> =GAS = ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE 1 YIN FEE CURRB <br /> Address Llcease# I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REG19T6RE0 I Y/ N MS CURREn Y/N <br /> Address License#F— <br /> PLUMBER — COMPANY mGOtiA— t r1Lx�C G cif`rj <br /> SIGNATURE eL <br /> REGISTERED FEECURM I Y/ <br /> Address l►oertsee 0 vr D <br /> MECHANICAL COMPANY <br /> SIGNATURE ALarC== I Y/N rile CURR T <br /> Address Llt�ns0 Et <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I YIN FEECIIRREA LyjN <br /> Address License I <br /> IIIIilllllltllllllllrlllllllllllllllll 11 { IIIi1111 { Ii11111111111111 <br /> RESIDENTIAL Attach(2)Plot Plana;(Z)sets of Building Ptenr(1)set of Energy F arms;R-O-W Permit for newconsWction, <br /> Minimum ten(1o)wonting days after aubmittal dale. Required one to,Construction Plane.StOmlwater PianS w/Sat Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Wok Permit for subdIlAsIons large projects <br /> COMMERCIAL Attach(2)complete seta of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)worhing days after submittal dote, Required one to,Construction Plans,stormwator Plana w/Sat Fence ineleaed, <br /> SeNtery FarA Iles&i dumpaler.Site Work Permit for So new prolE ots.All commercial requirements must meet eompaence <br /> SIGN PERMIT Attach(2)seta of Engineered Plans. <br /> "'PROPERTY SURVEY required for all NEW conatruction. <br /> Directions: <br /> Fin out application completely. <br /> Owner a.Contractor Stan tarok of application,notadacd <br /> if ovor$2500,a NoUeo of Commoneemont io rcqulred. (AiC upgrodoa ovor 600) <br /> " Agent(for the contractor)at Power of Attorney(for the=net)would be someone with notertze0 letter from owner authorizing aemm <br /> OVER THE COUNTER PERMITTING (copy or contract required) <br /> Refs if shingles Sewers SOMCA Upgradog A/C Fences(PIoIGurvc y/Footage) <br /> Driveways-Not over Counter if on public roadways,.needs ROW <br />