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813-780-0020 City of Zephyrhills Permit pplication Fax-813-780-0021 <br /> Building Departmen <br /> Date Received, � 1"� ' 1.:� <br /> ii Phone Contacipt for Permitting 1 <br /> Owner's Name J,0 "n Mass en 1 O ner Phone Number <br /> Owner's Address � � _-Fran acJ ner Phone Number <br /> Fee SimpleiTitleholder Name O nor Phone Number <br /> Fee Simplel,titleholder Address <br /> JOB ADDRESS J V�J(J O(� LOT# <br /> SUBDIVISION . �t ir.-T k u,3o — S- pP_A,RCEL ID# C�-L 2� - - i A - 0 L 4 0®2 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT = SIGN = = DEMOLISH <br /> y <br /> R -INSTALL 8 REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER . <br /> TYPE`OF CONSTRUCTION = BLOCK 0 FRAME = STEEL 0 <br /> DESCRIPTION OF WORK a <br /> BUILDING SIZE SQ FOOTAGE • HEIGHT •. <br /> =B,UILDING $ VALUATION•OF TOTAL CON TRUCTION <br /> =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY 0 W.R.E.C. <br /> f <br /> =PLUMBING $ � <br /> =MECHANICAL $ VALUATION OF MECHANICA INSTALLATION <br /> =,GAS = ROOFING SPECIALTY = THEIR <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> -BUILDER $ COMPANY <br /> SIGNATURE REGISTERED T/ N I FEE CURREN Y/N <br /> Addrei s License# <br /> .•:;'ELECTRI,CIi4N COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N. <br /> Address License# <br /> P.LUMBER..:.. COMPANY' <br /> SIGNATURE REGISTERED /'N r'` FEE CURREN Y/N <br /> Address License#- <br /> MECHANICAL COMPANY <br /> •'SIGNATURE, REGISTERED / N• = i , .FEE CURREr. ., Y/N <br /> Address':: License.# <br /> r OTHER; <br /> Scott Blackman Roofing, Inc. COMPANY <br /> SIGNATURE, " - REGISTERED /.N FEE CURREK Y/N <br /> Address'.=: San.Antonio, FL-33576 license# C C_C® <br /> .RESIDENTIAL,:,:, :Attach°_(2);:Plof;P.Ian's :(2)setse'of.Building Plans;(1)`set'of Ene'egy Forrtis B ,=1(V Pei nit for.new.constiuction, <br /> ;Minimum';tene(10):workingdays:aftersutimittal:iiate.'`Required`orisite;Cons ction'Plans;'`Stormwater Planss w/Slit Fence.installed,. <br /> Sanitary.lFacilities&s1;ydumpster;,Sit6;Worki Permit fotsUbdivisiona/large p�co ,cts:. <br /> MMERCIAL Attach(2)'camplefe sets if'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,Cons ction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.,Site Work Permit for-Al projects.All co mercial requirements;must meet compliance <br /> z SIGNrPERfNIT Attach'(2)sets;of Engineered'Plans:r- , <br /> '*"PROPERTY SURVEY.requfred for.all,NEW construction.., <br /> �;Directions:� _ - <br /> flll'out;application completely. <br /> Owner`&Contractor sign back of application,notarized <br /> If over$2500.a Notfce.of Commencement is required. (A/C upgrades over$7500) <br /> Agent'(for'th'econteaotor)or`Powerof Attorney(for'the owner)would be someone with notari ed letter from owner authorizing same <br /> —. <br /> ',OVER".THE CO I NTER;PERMITTING: .(copy.of contract-required) <br /> ' Retoofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public-roadways..needs ROW <br />