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Li1yOt Zephyrhills Permit Application Fax-818-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting Cx isko emuo)at i At McAekorito- com <br /> Owner's Name up(_In �nc Owner Phone Number <br /> Owner's Address e co m Iv- 1_71 0 3:�L Owner Phone Number <br /> -Fee Simple Titleholder Name <�-n Imp— Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS <br /> ' ' v <br /> auaDrNsKzN p/xRCELVD# <br /> ' wm.mmEu,x"mrxurEx/, /aamv`ICp ' <br /> WORK PROPOSED wewcomsTn *DD�J]' F--� O|GN F--1 F--1 DEMOLISH <br /> iNGTALL �_] REPAIR <br /> PROPOSED USE F--� � oFR � �-7 COMM [---1 oTHER <br /> TYPE OF CONSTRUCTION F�� BLOCK �-1 FRAME F---� GTEEL F--1 <br /> DESCRIPTION OF RK <br /> BUILDING SIZE SQ FOOTAGE[__` UZ_57 `' HEIGHT _ <br /> [--��U|LDi�G <br /> �--� VALUATION OF TOTAL CONSTRUCTION <br /> �--lELECTR\[�� AMP �--� P���R��8�NE��Y �-� VV.R.E.O. <br /> �� <br /> ' <br /> =PLUMBING <br /> =MEoM&N|CAL $ VALUATION OF MECHANICAL INSTALLATION <br /> GAS �-�� ROOP�G F-� � SPECIALTY OTHER�---1 <br /> � ���� ��. <br /> FINISHED FLOOR ELEVATIONS qo FLOOD ZONE AREA =YES NO <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <br /> mu|LDER COMPANY <br /> SIGNATUREREG/STsnco pEft CUnRE� YIN <br /> Address 0, M DO Uoenea# <br /> ELECTRICIAN COMPANY <br /> � <br /> SIGNATURE REGISTERED ` p���nn��REGISTERED <br /> Address License# <br /> P�U���� oo�PuN� <br /> ���N�rU�� REGISTERED �'/�� <br /> Address <br /> MECHANICAL <br /> SIGNATURE REGISTERED ^ <br /> Address Linnnsa# <br /> OTHER COMPANY <br /> SIGNATURE ��/snsnso � ����m <br /> . �_y __' <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans ;q sets of Building Plans;(1)set of Energy Forms;R-OuNPormit for new construction, <br /> Minimum ten(1V)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Slit Fence installed, <br /> Saoitory Facilities&1 dumpater;Site Work Permit for subdivisions/large 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(1O)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumooter�Site Work Penn�for sUnew pn�n�m./V|cnmmon�e|naquimmen�must meet compliance <br /> SIGN PERMIT Attach >sets ofEng(noeed Plana. <br /> ~`~~pRDPERTY SURVEY required for all NEW construction. ' <br /> Fill out application completely. <br /> owncr&Contractor sign back of application,notarized <br /> If over$25o0'a Notice nfCnnmmenoemartisrequired. (A/C upgrades over$75VO) <br /> = Agent(for the contractor)or Power of Attorney(for the owner)would bn someone with notarized letter from owner outboridn same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Remofs if shingles Sewers Service Upgrades A/C Fencws(z|ot/Suwey/FootaQe) <br /> Driveways-Not over Counter ifon public mmdwayu..neodoROW <br />