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813-780-0020 o � /0'5 Fax-813-780-0021 <br /> City of Zephyrhills Permit Application <br /> Building Department <br /> Date Received <br /> I Phone Contact for Permitting - <br /> Owner's Name r' ( 1 9P' Q �l. `Z� Owner Phone Number / 3'" ©" qq <br /> Owner's Address z2 eha,V II , 2G h,1 F� <br /> � wner Phone Number <br /> Fee Simple Titleholder Name F Owner Phone Number <br /> Fee Simple Titleholder Address 7 <br /> JOB ADDRESS ZOO lVachoviudle '1 S 51-to LOT# <br /> SUBDIVISION F PARCEL ID# q5 bJs-a'_v lLaO`CCCW` 13(.40 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED ® NEW CONSTR R ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK Q FRAME = STEEL = <br /> DESCRIPTION OF WORKN� a ' T G� N V Q C <br /> BUILDING SIZE :11SQ FOOTAGE HEIGHT <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ <br /> MECHANICAL $5 C®a GCr VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = J ROOFING Q SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURI= REGISTERED I Y/ N FEE CURREN Y/N <br /> Address I License# <br /> PLUMBER COMPANY <br /> ,SIGNATURE REGISTERED I Y/ N FEE CURREN <br /> Address I License# <br /> MECHANICAL COMPANY 11I. I ZC Seau 1u! <br /> SIGNATURE pp REGISTERED Y/ N FEE CURREN Y/N I <br /> Address VCOO �2 h R h t License <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> —RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building,Plans;(1)set of.Energy Forms;R-O-W.Permit for new construction, <br /> Minimum ten-{10}working-days-after_submittal.date.'.Reguired:ons)te,Construction Plans;Stormvl ater Plans w/Silt Fence installed, <br /> Sanitary Facilities&.-Aumpster;:Site WqR.P76rh(t f6r subdlvisio(s/laige projects- -;- -.--= <br /> COMMERCIAL Attach(2)complete,sets;of Building Plans plus;a L'ife,Safety Page:,(1)setof Energy Forms:R-A=W P_emutfornew.construcdon:, <br /> Minimum;ten(1,0)workingrdays after submittal datei Required onsite Coristructiori Plans`Stormwater Plans w%Silt'Fence mstailed; <br /> Sanitary,Facilities;&1-;duinpster.'SiterVllork'Permit for.`;all new:projects.All.commercial'requirements musf:meet compliance <br /> SIGN PERMIT Attach(2)•§etsof Engineered Plans <br /> "'"PROPERTY,SURVEY;r,`eguired:for,all NEW, ,-construction: <br /> Directions: <br /> Fill:outa licationcom completely. <br /> ,P, .yr' <br /> Owner&Contractor si n.back.of;a licatiom,"notanze <br /> 9,. PP.. <br /> If over:$2500,a'Notice"of Gomm®ncement:is're wired. AIC.a rades•'over$7;500 <br /> " Agent(for the contractor)or Power of Attomey.(for the owner)would be+-someone with,notarized°letter'fcom ownerauthonzmg,same�; -' <br /> COVER.THE COUNTER PERMITTING" : co f contract <br /> required) <br /> Reroofs if shingles Sewers• Service;Upgrades`-A/C:" Fences::iPiot%Sunce IFoota 'i§j''; 4. <br /> Driveways-Not ov r Cou nterif on. ublicnad 'a'y•s.:'inee'ds,-ROW _- <br /> _: , <br />