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813-780 -0020 City of Zephyrhills Permit Application , 1 t ( S Fax -813- 780 -0021 Building Department ` / 6 Date Received _ ,/"— M Phone Contact for Permitting 0 3 , a f -- M Owner's Name emarle A nctVd P)ioX so ) Owner Phone Number 5I3 — L I 3, a Owner's Address J ` 11-) + a rY I.1O 10 Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address � JOB ADDRESS r1 I ' rIVCADUOCOd LOO ( LOT # in SUBDIVISION fteatouLoo6 es es PARCEL ID# 1:6-au: a t -Cato -c rat. 0 tot(J (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN I I MOVE I I DEMOLISH INSTALL I REPAIR PROPOSED USE I 1 SFR 1 1 COMM 1 1 OTHER 1 1 TYPE OF CONSTRUCTION I 1 BLOCK 1 ? 1 � ,FRAME ��__ �� STEEL I 1 OTHER I I DESCRIPTION OF WORK �n 1. ' i b Ie ��' rjklel -LL, n.5 X Zy ' Poot. t✓oC \060C BUILDING SIZE SQ FOOTAGE HEIGHT IX 1 BUILDING $ VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 1 PROGR SS ENERGY I 1 W.R.E.C. PLUMBING $ p( -40 F - f/T ' (4)A -- j og ' 1 I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �' l l TH fig N I I GAS I I ROOFING I 1 SPECIALTY I 1 OTHER / C FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES I (NO • BUILDER ,1(�►� �k ��G 1 1J (' COMPANY �? * (*-t" c.), ' _._Lr 'c.), EY SIGNATURE 1 t v� / � `/` 1 �I REGISTERED I Y/ N j FEE CURRENT I Y/ N I Address , L IZL`(c C 1 y S �Ciaa ZQ yY ( N ∎\\ ‘451-> License # 5W( 3 1 k LW) 19 l ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y / N 1 FEE CURRENT I Y / N 1 Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y / N 1 FEE CURRENT I Y/ N I Address License # OTHER COMPANY SIGNATURE REGISTERED I Y/ N _I FEE CURRENT I Y/ N I Address 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, 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 wI 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 Sewers Service Up A/C Fences (Plot/Surve /Foota•e) Driveways -Not o r Cou l K p ' adways flpVil MIITSAM 2 C11461431,1 *:Pt1t}t ie y cJe. :.,it! v s `t , Iii, ". �' ,,\,^ 0 gid1014 ID 141: aii1U ilii*Ci4 • .';;;"e stV: lilt , t'cit., t . "I vM �,t • ' • p, 5F w , ,� ` ►t ' NA asuZK3 mtr!o� ~,tlYl � 4 . ,r,., - 2 >?.tie 001tr ti+i c, ( ��mres mc� s `.3e6 ,,o A .,, ii: 1 IRA (1f M IMAM tt 7:00 Qnbillt