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813-780-0020 <br /> City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitfffig 32-1 <br /> LJ.LL ............ ............. ... ........ <br /> Owner's Name re,IsDn ...... Owner Phone Number <br /> Owner's Address[7-- Owner.Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> k <br /> JOB ADDRESS F577T ILA [Is -41335q(_)1 LOT# <br /> SUBDIVISION. PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR&J ADD/ALT. Q SIGN Q 0 DEMOLISH <br /> e- ' INSTALL REPAIR <br /> PROPOSED USE Q SFR 0 COMM Q OTHER I <br /> TYPE OF CONSTRUCTION Q BLOCK) Q FRAME, STEEL <br /> DESCRIPTION OF WORK Menoc- _Tj,)5+ai1a,4ioy) 511-x.� f)0aTd 0/1 N-O-)IJ <br /> BUILDING SIZE SQ FOOTAGE=. HEIGHT <br /> =BUILDING 1$ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL VALUATIOkOF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> MH f7k Y)ck 4,e nc(tq 5 LLq <br /> BUILDER COMPANY.t PANY I ()y <br /> SIGNATURE REGISTERED ICY4 N FEE CURREN 1, Y/-N - J <br /> I DrTnne_r�s+ r <br /> Address License# [L- 7 to <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN. <br /> Address F License#1 <br /> ANY <br /> COMP PLUMBER REGISTERED RED Y/ N FEE CURREI, <br /> SIGNATURE %L_yj N_J <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED' Y[-N , 'FEE CURREh <br /> Address- License# F_ <br /> HER COMPANY <br /> IGNATURE REGISTERED, Y/ N - -FEE C.URREh- <br /> Address License#.,E— <br /> +1111 11 11.1 1-H.1 11,11.1111 Hi H 111111111111111 1 111 H 1.1111 li!11 H H!1111 1-H! <br /> E&DENTIAL Attach(2)Plot Plans;,(?)sets of Building Plans;,(I,)set-of Energy,Forms;,R-O-W Permit for new construction,- <br /> date. Required on's'ite-Constructibri'Plani Stormwatee,Plans wl Slit Fence Installed, <br /> Minimum ten(10)working days-a ' projects <br /> Sanitary Facilities&I dumpster,,Site Work Permit for subdivisions/large <br /> OMMERCIAL 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 afters6bmittal,datd.-.Raqu:lred;onsite,Construction-Plafis;-Stormwlater•Plans w/SlItfence installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all n.ew.prolects.Ail commercial requirements must meet compliance <br /> GN PERMIT Attach(2)sets ofZngIneered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> ctions: <br /> Fill out application completely. <br /> Owner&Contractor signback of application,notarized <br /> it over$1500,a MotlGg of COMM9noerngnt is required. (AJC upgrades over$7500) <br /> with o thbrIz7 <br /> Agent(for the contractor)or power of Attorney(for the owner)would be someone notarized letter from owner authorizing same <br /> FaTtar.owleR FoRwrims t�D1l of required)ces'(Plot:/Sur�eyffiootage) <br /> Ola if shingles'' ,-Sewers" -,''-Service-Upgradei. AIC Fen <br />