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Ole $So -7 <br /> s1317sa-ao2a City of Zephyrhills Permit ApplicatioT � �7 f Fax-813-780-0021 <br /> Building Department <br /> Date Received r7 Phone Contact for Permitting tr <br /> Owner's Name 4 L ��r�� � l_ Owner Phone Number (�1 )— j�\S31� <br /> Owner's Address Owner,Phane Number <br /> Fee Simple Titleholder Name Owner Phone Number �. <br /> Fee Simple Titleholder Address y <br /> JOB ADDRESS 1 �' i L LOT# <br /> SUBDIVISION PARCEL ID# )- i\ CL2QC)_,�`l 0 <br /> 6 {OBTAINED FROM PROPERTY[TAX NOTICE) <br /> WORK PROPOSED R <br /> NEW CONSTR e ADD/ALT SIGN Q MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION BLOCK (r Q FRAME STEEL Q OTHER <br /> DESCRIPTION OF WORK �'C� O 0� \LP �C 1 �Y�l{1 � <<1 C�OS{-� <br /> BUILDING SIZE F SQ FOOTAGE —� HEIGHT <br /> 0 BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION <br /> I <br /> Q ELECTRICAL 1$ AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> 0 PLUMBING <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> Q GAS Q ROOFING SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES QNO <br /> i <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# �— <br /> i <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED L_Y/ 11._j FEE CURRENT <br /> Address I � License# 1i � <br /> MECHANICAL \ j �— COMPANY Ion'11'�an Ln I r <br /> SIGNATURE v ✓ter �� REGISTERED I Y/ N I FEE CURRENT I Y!,N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> _ _Address _ _ _License# i 1 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms I <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpster <br /> COMMERCIAL Attach(3)sets of Building Plans;(1)set of Energy Forms. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpster <br /> All commercial requirements must meet compliance. <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> i <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$5000) <br /> I <br /> ** Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW ! <br /> 7 j <br />