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W S 19 3 F'az, A 6 71 1 s l'(0 2 E5 <br /> 913- 780.0020 City of Zephyrhills Permit Application <br /> Fax <br /> Building Department <br /> 6 /Dyg,7 <br /> Date Received / 0,� L 1 0 Permi <br /> - n - I - mUT- V / Phone Contact for ttin Z�q <br /> - - •- C , , - ri u g ) q36 - <br /> 7 <br /> Owners Name (,(f �C d N `tZ <br /> Owner Phone Number 711 4 ( • 32y - Lf 2._te <br /> Owners Address 1/530;(g6244, Cf/tri L NC L8236-4 2 1 1 F 6 Owner Phone I <br /> one Number I <br /> Fee Simple Titleholder Name I - S/1}vn..t._. I I <br /> Owner Phone Number <br /> Fee Simple Titleholder Address I .. <br /> ` I <br /> (p <br /> JOB ADDRESS 1 5 3 0 5 - -gr ! LZ cr. gy2 ti(lfl / .H• ?- 1 LOT# I /f <br /> yp I <br /> SUBDIVISION 1 aireflye /!� I PARCEL ID# I �l / — 4 �'p °L/ - 00 /0 - /Slim - 0/9 O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED I I NEW CONSTR ADD /ALT l'.1 ( L SIGN I <br /> INSTALL H REPAIR _I DEMOLISH <br /> PROPOSED USE SFR n COMM 1 1 OTHER I <br /> TYPE OF CONSTRUCTION F BLOCK I FRAME ( I STEEL I <br /> I <br /> DESCRIPTION OF WORK 1 see, ti A--C t .} C ) ( <br /> r � P_ r1 I � CC r£ t vie f -stn r -4-4 a Poi & 11 b <br /> BUILDING SIZE I 1 SQ FOOTAGE I 24-7 1 HEIGHT I I <br /> 1 (BUILDING I MOO— VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL I$ I AMP SERVICE <br /> 1 PROGRESS ENERGY ri W.R.E.C. <br /> 1 IPLUMBING I$ <br /> (MECHANICAL 10 I VALUATION OF MECHANICAL INSTALLATION <br /> ETGAS 1 1 ROOFING 0 SPECIALTY ' 1 OTHER <br /> FINISHED FLOOR ELEVATIONS <br /> 1 I FLOOD ZONE AREA <br /> I (YES NO <br /> BUILDER COMPANY I <br /> SIGNATURE REGISTERED 1 Y / N 1 FEE CURREN Y / N <br /> Address 111- I I <br /> /1/4-C- License # f <br /> ELECTRICIAN ' ,' / f, p <br /> I COMPANY I <br /> t ( RR L I <br /> SIGNATURE lF / p L C[7 / ,� �f� REGISTERED Y / N FEE CURREN <br /> Address 31 _l �p . ., '- -' K. 336(5 s <br /> License # I L c--000 3 /5 1 <br /> PLUMBER COMPANY I I <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURREN 1 Y/ N <br /> Address I <br /> 1 <br /> License # I <br /> MECHANICAL COMPANY ( I <br /> SIGNATURE <br /> REGISTERED 1 Y/ N I FEE CURREN 1 Y/ N <br /> Address ! I <br /> r..... License # <br /> ir <br /> OTHER <br /> SIGNATURE 1 ) COMPANY ( Scga t M r <br /> r REGISTERED Y/ N FEE CURREN I'/ N <br /> Address I C © / q 63 Z <br /> 111111111111111111111111 1111111111 1 111 # 1111111111111111 <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; 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 Permit for new construction. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster. Site Work Permit for ali new projects. Ail commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans, <br /> — PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement Is required. (NC upgrades over $7500) <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 Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />