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City of Zephyrhills Permit Application Fa»813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> Ir <br /> Owner'sName Owner Phone Number C� <br /> Owner's Address -Dy- Mamon 3 Owner Phone Number <br /> Fee Simple Titleholder Name Own'or Phone Number <br /> Fee Simple Titleholder Addmss <br /> BUILDING SIZE SQ J FOOTAGEE��---q f4- HEIGHT <br /> JOB ADDRESS F(A.37- <br /> PARCE <br /> (OBTAINED FROM PROP15RTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> Ef INSTALL E REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME STEEL <br /> ' <br /> F--lBU�DU1� <br /> �� VALUATION <br /> F--lEL�CTR{�L ��P8ERV|�� �--7 PROGRESS ENERGY F—� w�R�I. <br /> -__' <br /> F--lpLUM8\NG <br /> F---l�ECHANk��L ~ e <br /> ���� <br /> wo <br /> F--lGAg F—,�~ RDOFlNG [—1 SPECIALTY \ | OTHER <br /> FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA =YES NO <br /> BUILDERC��PANY <br /> SIGNATURE REGISTERED L_I���_� 'Ei-cu«xE^ L11 N__J <br /> Address License# <br /> ELECTRICIAN coMrxmx <br /> SIGNATURE nso/STEneo L_l/ N _] FEEcunnc^ L_Y-/N_� <br /> Address License# <br /> PLUMBER70 �O�P/UoY <br /> SIGNATURE neo/oTsnso LY/ N 'psscunmsu LYIN_J `= <br /> Address unanue* <br /> MECHANICALESIGNATURE ` L--(/-N FEE cunnex ��_J . <br /> Address � u onoe# <br /> OTHER <br /> SIGNATURE REGISTERED Y/_N_ psscunaEN LY Il�_1_^ <br /> A4dr*sm Livenoo# 5-33.3 <br /> nxxuuxnunm � oxuunxuuu � � x^um � mK �� K � � xxx � Nxxxxxmnxxxmmxxxumxxxxmmxxxxwu <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R'O4Y Permit for new construction, <br /> Minimum ten(1o)working days after submittal date. Required onoite.Construction Plans,0nnnwmter Plans o/Silt Fence installed, <br /> GanitaryFa�|�es&1dump� � <br /> � S}haYVnrkPmnnit*orsubd&i�nna�argepn4ods <br /> COMMERCIAL /��nh(u)complete sets o[Building Plans plus o Life Safety Page;(1)set of Energy Forms.R,O4m Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required oneita.Construction Plans,Shz,mva0ar Plans v/Silt Fence installed, <br /> Sanitary Facilities&I dumoster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans, <br /> ""PROPERTY SURVEY required for all NEW construction, ' <br /> F0 out oppUcstioncompletely. <br /> Ownnr&Contractor sign back of application,notarized | <br /> If over$uson'a Notice pr Commencement isrequired. (AIC upgrades over$Too0) <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 (copy nf contract required) <br /> Ramofs if shingles Sewers Service Upgrades A/C Fommm(P|oUGurvey/Fpotage) ' ^ <br /> � <br /> Driveways-Not over Counter ifon public modvaya..neodaROW <br /> ' ^ . <br /> ' <br />