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313 -780 -0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department )4( 01 ( 5 pate Received Phone Contact for Permitting a ' 6g -- 0- 3S tltiIltItfItIIILLIIP e I� Owner's Name m 1 �- 4 'Q El.) E G 1 a � /3 Owner Phone Number 4 � - '75,A - " / 6 Owner's Address 3 76 D i e D h /9 V £ Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 376 Y $ 06 E /C_1 M 71 UE LOT # / SUBDIVISION G RA )S 6 /T-a R j ZoArs3 PARCEL ID# 3 - DI - a 0 9 D - G OW& - 61 L J (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT 1 1 SIGN n MOVE 1 1 DEMOLISH INSTALL . REPAIR PROPOSED USE 11 SFR 1 1 COMM 1 1 OTHER 1 I TYPE OF CONSTRUCTION I I BLOCK 1 1 FRAME 1 1 STEEL n OTHER 1 I DESCRIPTION OF WORK in IL c he.. O t T " 3L, ' Is KGJ - 13 6 eE iQ P a erk_Q BUILDING SIZE SQ FOOTAGE HEIGHT I 1 BUILDING $ VALUATION OF TOTAL CONSTRUCTION I 1 ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY n W.R.E.C, PLUMBING $ I 1 MECHANICAL $ 30 9 O VALUATION OF MECHANICAL INSTALLATION ' I GAS 1 1 ROOFING 1 1 SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 'YES n NO BUILDER COMPANY SIGNATURE REGISTERED 1 Y / N 1 FEE CURRENT 1 Y/ N 1 Address 1 License # ELECTRICIAN COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y / N 1 Address I License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I Address 1 License # MECHANICAL �, ( �� Q COMPANY I A C,C i n C.1) iS 6 ELE SIGNATURE �° _ �\ �) REGISTERED I / N I FEE CURRENT I N I Address 90q3 i • Al EmO R / F1 A3 1, v 6 License # CAe 3 ?7,.5 `5 OTHER COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N 1 Address License # I 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, Stormwater 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 & 1 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: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) 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 A/C Fences (Plot/Survey /Footage) -4(.1:h.. A ^ i.ait. -41U Driveways *Wier Coupler iftctIMP li000ad ROW