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813-780 -0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Bidding Department <br /> d _`�e <br /> q1 3z <br /> %41... s, -' Phone Cordact for Permitting 4 tfE 9 ► : -1 s 1 <br /> I <br /> Owner% Name 14C-. FL 11S LIZ Q� Q� 7�1 Owner Phone Number r. * p 5 � ' C I 3bR <br /> G. <br /> Owner Address 1( C n I . � �� ��OIC.{.� R.G.I ( 63 1 01 Owner Phone Number 11 13 r l O 3 • 1 1 <br /> :ILL '� , <br /> lc.. t Z <br /> Fee Simple Titleholder Name NA- Owner Phone Number 1 <br /> Fee Simple Titleholder Address 1 <br /> JOB ADDRESS i q 02-- Laurel. y V CAM blvd. . / N I 1 Jf l�] r \ \ 1 l 1 LOT I SUBDIVISION IV <br /> SUBDSION elf L tc sags PARCEL ) GAT t • �'Zl - _1 Web cX Cf >>- M J <br /> (OOTAR1® PROM PROPERTY TAX NO710E) <br /> WORK PROPOSED E NEW CONSTR H ADD/ALT n SIGN Q MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 1 +er SFR n cow Q OTHER I <br /> El TYPE OF CONSTRUCTION BLOCK f1 FRAME n STEEL OTHER <br /> DESCRiPTK1N OF WORK t! ies ___ 6 . V.. g a ak - t r - . s :i. • ■ -alb • t . _lk ik <br /> UIL <br /> BDING SE I M 1( '3 SQ FOOTAGE 1 5 i$ HEIGHT 1 1 <br /> BUILDING li.11111_ VALUATION OF TOTAL CONSTRUCTION Z Ic. . 00 <br /> �, <br /> ELECTRICAL s I AMP SERVICE Ei PROGRESS ENERGY n W.R.E.C. <br /> 17 _N III <br /> r -.. PLUMBING liMi� <br /> re,>• <br /> EiZi <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> Q GAS n ROOFING n SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS 1 FLOOD ZONE AREA nYES O <br /> BU COMPANY 1 ( / KJ Mobile„ #d Sv c. <br /> SIGNATURE I P 14.1..._. REGISTERED N ' FEE CURRENT 1(4/ N <br /> 1 <br /> Address 1411.1/ NW (03rd Ave. Jerininls R 52045 ^ , License# IIN <br /> ELECTRICIAN / ' % J , * r �r C r / Q COMPANY V J \G <br /> SIGNATURE I .(LJ•L( (�,(,(/,(�, <br /> "-i935 Paler) REGhsTERED 1 N .. LiFEE CURRENT 1 ((Y) } N I <br /> Address I 0-1-is a. 4(6115F Q <br /> # (Fr p Io I <br /> PLUMBER //� / COMPANY {A <br /> Mobile. fck N • <br /> SIGNATURE / L REG STERED N 1 FEE CURRENT <br /> Address , N W l o 3 r . r V ( . `i A" 4,„ ,..3 Ltense# <br /> f I IH• 000021b 1 <br /> MECHANICAL COMPANY 1 L ACS ktl�. <br /> SIGNATURE � (� ,` REGISTERED It'd/ N 1 FEE CURRENT J (YJ N 1 <br /> Address I*M l T /�f Rd. <br /> . 7e phr hi\15, 1 License # ILA .t'4 RL1 /y 1 <br /> OTHER COMPANY <br /> SIGNATURE <br /> REGISTERED 1 Y/ N 1 FEE CURRENT l Y/ N 1 <br /> Address 1 License 1 1 <br /> RESIDENTIAL Attach (2) Plot Plans: (2) sets of BuidiiI Plane; (1) set of Energy Fauns: R-O-W PemI for new construction. <br /> Minim me ten (10) wafting days after submittal date. Regt*ed onstte, Construction Plans, Sir Plans w/ Silt Fence raped, <br /> Sanitary Fadpties & 1 durpste Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Pe n it for new construction. <br /> Minimum ten (10) waking days after submittal date. Required ornslte. Construction Plens, Stomnwaler Plans w/ Sit Fence installed, <br /> SIGN PERMIT S Facipas & 1 clumsier. Site Work Permit for all new projects. M commercial requirements must meet canptiance <br /> (2) sets of Engineered Plans. <br /> "'•PROPERTY SURVEY required for all NEW construction. <br /> ' Directions: <br /> Fi out appllcadon 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 /> •• Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Apppcapon Only) <br /> Reroofs Sewers <br /> Service Upgrades NC Fences (Rot/Survey/Footage) <br /> Driveways -Not over Counter if on public roadways..rnceds ROW <br />