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e13-78M020 City of Zephyrhills Permit Application Fax-813.76Oa21 <br /> Building Department - �j, r� <br /> Date Received �� Phona Contact for PermittingF;: is/�i —1 G7� <br /> -rrrl rT-rl m �t-r/ <br /> Owner's Name �J; 1 Owner Phone Number ^t1 <br /> Owners Address owner Phone Number <br /> IN i <br /> Pee Simple Titleholder Name DrI!r p)renn N_:^a__r l <br /> fee Simple Tltleholdi(r Address <br /> JOB ADDRESS { 1 LOT# <br /> SUBDIVISION \Lte'YG�C��} l PARCELtDrf <br /> 'i (OBTAIIIED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CoNSTR 8 ADD/ALT SIGN 0 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Imo) ry— > ^? I <br /> TYPE OF CONSTRUCTION 0 BLOCK FRAME L�J STEEL 0 <br /> DESCRIPTION Of WORK <br /> BUILDING SIZE �^ SQ FOOTAG= HEIGHT L� J <br /> BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL L � AMP SERVICE Q PROGRESS ENERGY = W.R.E.C. <br /> r <br /> &2rpLUMBING S <br /> =MECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA =YES NO <br /> i <br /> :ItLDER E�E COMPANY I <br /> SIGNATURE I REGISTERED I Y/N FEE CURREN LjILNj <br /> Address License <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN <br /> Address _ License#I <br /> ^+. �C l.Gsc�rri�rr`ry <br /> PLUNr!!ER '��J'' COMPANY <br /> SIGNATURE ll.-'`_ hEtS16MRED /`.►K[N "0 FEECURRE YIN <br /> Address t CY1� License# �t���C <br /> MECHANICAL COMPANY <br /> SIGNATURE I Y/N FEECURREN Y/N <br /> Address License# t <br /> OTHER COMPANY ^� <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN Lj!N <br /> (address ( License a <br /> / tiittttllttiitittlttiit { I { tltitil { It1IIIIt1IIlI1111111111111111111 <br /> HESIOENTIAL Attact6(2)1-tot mans;(/)sets or ounaing flans;(1)set of tnergy"rms;K-Q-w t emvt for new construction, <br /> Minimum ten(10)working days after Submittal date. Required onste,Construction Plans,Stormwater Plans w/Sitt Fence installed, <br /> Sanaary Facilities&t dumpster,Site Work Permit for subdivisionsilarge projects <br /> COMMERCIAL Attach'(2)complete sets of Building Plans plus a Lde 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,Constructon Plans,Stormwater Plans w/Silt Fence installed, <br /> SanitaI Facilities&1 dumpster.Site Work Permit for all new projects.Ail commercial requirements must meet compliance <br /> SIGN PERMIT Attach7(2)sets of Engineered Plans. <br /> ...PROPERTY SURVEY required for aft NEW construction. <br /> .1 i!I.i I 1 ' 'a.ai I.6d.1 i 4a�rx t• t a •a t - 6.t <br /> Directions: <br /> Fn4 n.+r ^!'^"t: . .,r„np!etet}. <br /> Owner&Contractorsign back of application,notarized <br /> B over$2500,a Notice of Commencement is required. (AlC upgrades over$7500) <br /> •• Agent(for the contractor)or Power or Attorney(for the Owner)would be someone%ith notarized loiter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Rarools if shingles sewers , Service Upgrades AIC Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways.,needs ROW <br /> i' <br /> I. <br />