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e137aa9ozo City of Zephyrhills Permit Applicabon Fax-613.78D.0921 <br /> Building Department <br /> gals Received Phone Contact for Permitting <br /> Owner's Name ► I Owner Phone Number <br /> Ownees Address Ormer Phone Number <br /> Fee Simple Titleholder Naine Owner Phano Numbor <br /> Fee Simple Titleholder Ad ireSS <br /> JOB ADDRESS \ Oc L07# <br /> SUBDIVISION d PARCELID$ <br /> losrntrrro FROM aaoaenTYTAX NoncEl WORK PROPOSED B NEW CONSTR 8 DEMOLISH <br /> ADDIALT = SIGN = _ <br /> ii 'INSTALL' REPAIR <br /> PROPOSED USE i = SFR = Comm L J OTHER <br /> TYPE OF CONSTRUCTIOb BLOCK FRAME ®�STEEL Q + <br /> DESCRIPTION OF WORK, �CJ�� { <br /> BUILDING SIZE SO FOOTAGE= HEIGHT <br /> =BUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> =SLECTRtCAL S' AMP SERVICE = PROGRESS ENERGY W.R.E.C. <br /> LUMBING S O Lo <br /> [MECHANICAL 5 reVAALUUAATiIOON OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING Q SPECIALTY= OTHER <br /> FINISHED FLOOR ELEV rIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/N FEECURReI I YIN <br /> Address I Licenseff <br /> ELECTRICIAN f` COMPANY <br /> SIGNATURE I' REGISTERED I Y f N I FEE CURRM Y I N <br /> Address License# <br /> PLUMBER COMPANYESE�m� � <br /> SIGNATURE REGISTERED FEECUiiiiiN YIN <br /> Address <br /> Lioensa>; e' Q <br /> MECHANICAL COMPANY <br /> SIGNCTLIRE RLawTttT� I YIN recGUTW I YIEJ— <br /> Address License# <br /> OTHER ElCOMPANY <br /> SIGNATURE REGISTERED I YIN FEECWmB Y/N <br /> Address ticensa# <br /> tf � � t � � t � � ft,� tletttttf � fr � tt � � ttittltR; ef � rs � tto � f � tfti � � � � I � � � i � � it <br /> RESIDENTIAL Attach 2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minim m ten(10)woriting days after submittal date. Required onsite,Construction Plans,Stormwater Plans wf Silt Fens installed, <br /> Sanita Faciiilies&1 dumpster.Site Work Permit for subdivisionsnarge,projects <br /> COMMERCIAL Attach 2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forma,R-O-W Pemtit for new construction. <br /> M(rdm m tan(10)working days after submittal dato, Roqulrad onsite,ConctrucHan Plano,Starmwater Plans w/Silt Fence installed, <br /> S2nita q Fae➢flies&1 dumpater.Site Work Permit for all new pralacts.All commercial requirements must meet compliance <br /> SiGN PERMIT Attach 2)sets of Engineered Plans. <br /> PR)PERTY SURVEY required for ail NEW construction. <br /> . . . .. . . . . . . . . . . .. • . . .. k . . k . .�. ......�d <br /> Directions, <br /> Ffl out appbcadorAM Pletely. <br /> & rctOwner aor a gn'basic of application,notarized <br /> If ovor$2600,n Nott:o of Commoncomont le roquirod. (A O upgrades ovor 07600) <br /> Agent(for tho contr lor)or Power of Attorney(for the mvner)would be someone with notarized totter from owner authorWng Same <br /> OVER THE COUNTER P RMITTING (copy of contract required) <br /> Reroms If shingles S.vats Seftrlco Upgradga A/C Fences(PtoUSuny/Footage) <br /> Driveways-Not over ounler if on public roadways„needs ROW <br />