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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for Permitting — Owner's Name _RN C h 1 p S e its — 4 ST PAS CO ..: ,, _ Owner Phone Number A i " ' SS l / Owners Address l BY7 Ai, Atom) (cc A ve /tN�� 3 Phone Number 1 I Fee Simple Titleholder Memel I 1 Owner Phone Number I I Fee Simple Titleholder Address J j_ �/ JOB ADDRESS 1 6/3110 6A /I 81 Jo/ zephyrh{' //s 33S (Z LOT0 I I SUBDIVISION I 1 PARCEL 1011 ea — 26 t Z /. oDio r Dzyoo r au 6 I (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED t . NEW CONSTR ADD /ALT 1 SIGN = MOVE E DEMOLISH INSTALL �� REPAIR PROPOSED USE Q SFR COMM Q OTHER 1 TYPE OF CONSTRUCTION 0 BLOCK E FRAME STEEL Q OTHER 1 I DESCRIPTION OF WORK R e-p I ftc e 2- / /S-7^Q' A/C 6y S/eM S I BUILDING SIZE 1 1 SCI FOOTAGE I 1 HEIGHT I Q BUILDING $ I VALUATION OF TOTAL CONSTRUCTION E ELECTRICAL $ AMP SERVICE E PROGRESS ENERGY Q W.R.E.C. E PLUMBING $ p g MECHANICAL $ .5// 70, ef o I VALUATION OF MECHANICAL INSTALLATION Q GAS Q ( ROOFING I I SPECIALTY OTHER FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA EYES ENO BUILDER COMPANY 1 SIGNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y/ N I Address I 1 License # I I ELECTRICIAN COMPANY I SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address 1 I License # PLUMBER COMPANY I I SIGNATURE REGISTERED I Y / N 1 FEE CURRENT 1 Y/ N 1 Address -IIIIIIIIIIIIIIIIWAFAIIra— License # I MECHANICAL / e COMPANY 1 L M ;I i d ill . it. CO /U d I )[ lf0N 1' ,t/ !Jf 1 SIGNATURE r .Li�.�riLi[ '�� rt! �� 1♦ � REGISTERED 1 Y/ N 1 FEE CURRENT J Y/ N 1 V Address r "!17 3 773 License # I CA C 2 23 Slv OTHER COMPANY 1 SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT 1 Y / N 1 Address ( I I License # RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster, Site Work Permit for subdivisions/large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities 81 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. '""'PROPERTY SURVEY required for all NEW construction. Directions: D: Fill out application completely. Owner & Contractor sign bads of application, notarized If over $2500. a Notice of Commencement is required. (A/C upgrades over $3000) " Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) Driveways -No( over Counter if on public roadways..needs ROW