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06/01/ 13:49 3525674454 MILBAR PAGE 01/01 <br /> 813 -780 -0020 City of Zephyrhills Permit Application Fax -813- 780.0021 <br /> - Building Department <br /> Date Received I J Phone Contact for Permitting 1 n1 - <br /> I. <br /> tees Name 21 I Owner Phone Number S .-1 . • - .. <br /> Owner's Addre s Owner Phone Number <br /> Fee Simple Titleholder Hamel If 1 I Owner Phone Number ( <br /> Foe Simple Titleholder Address 1 N (A • 1I <br /> JOB ADDRESS I AR 07_42_ 14 /G/rntnt ;1< <br /> 7rirt yr1 \ 3g44z 1 LOT* 11, <br /> /J l t' <br /> 11, Z, 3 1 <br /> SUBDIVISION 1 1 PARCEL ID# I /! 0 G a2 /' TiD/G � -- �� <br /> (OBTAINED FROM PROPERTY TAX � t <br /> E1 <br /> WORK PROPOSED NEW CONSTR s ADD /ALT Q SIGN Q MOVE f• DEMOLISH <br /> B INSTALL REAI r <br /> PROPOS USE ED SFR Q COMM d OTHER 1 Re. I . <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL r OTHER r I � —\ <br /> !� ' i c sh:o.4t, F 4 t 544 , �- � <br /> \ I <br /> DESCRIPTION OF WORK 1 Shwlgt< t:e,Q<a "Sr 1 artl X' t< 2.'S `) 1 , . � <br /> BUILDING SIZE I SQ FOOTAGE I HEIGHT 1 ; I qi � <br /> Ir BUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> I <br /> ?S 7Z.10 <br /> Q ELECTRICAL IS AMP SERVICE Q PROGRESS ENERGY 0 W.R.E.C. <br /> r n , l �i <br /> 0� � . <br /> 1 1 PLUMBING IS <br /> ` �-► <br /> ED MECHANICAL S ' VALUATION OF MECHANICAL INSTALLATION 13 , ✓n / <br /> Q GAS ©-- ROOFING SPECIALTY Q OTHER I 1412 <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA r]YES NO l <br /> g"O ( / / //� /� COMPANY I MI I' • r eonsIruG'�1 Zre <br /> SIGNATURE / l ,a-<-4 YIJ/�`�(- / REGISTERED a N FEE CURRENT N l <br /> Address 1 15q►I UP So) 'Dade C.145 33 33 1 License# I erc051 V - <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N I I FEE CURRENT ' Y / N I <br /> Address I U License* <br /> PLUMBER COMPANY 1 <br /> SIGNATURE _ REGISTERED I Y/ N l l FEE CURRENT I Y/N I <br /> Address I l LiCenae It I <br /> MECHANICAL COMPANY 1 <br /> rr,NATURE REGISTERED I Y / N _1 FEE CURRENT I Y / N I <br /> Address 1 License # 1 <br /> OTHER <br /> SIGNATURE REGISTERED I <br /> I Y1 N _I FEE CURP.SNT I Y l N 1 <br /> Address I ,I License# I <br /> .A <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy f=orms <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 white, Construction Plans, Sanitary Facilities 8 1 dumpster <br /> All commercial requirements must meet compliance, <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> *PROPERTY SURVEY required for all NEW construction. <br /> ructions: <br /> FIJI 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 /> '< Agent (for the contractor) orPdwer Attorney (fdrthitaNner) would be someone with notarized ietterfromowner authodzing same ' <br /> OVER THE COUNTER�isERNITTING • ,( of Appiltaliofl Only) <br /> Reroofs Sewef8 'Service Upgrades : A/C Fences (Plot /Survey/FOotage) • <br /> i F <br /> Driveway's -Not over Counter If on public rosdways skids ROW <br />