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a�s-�aaoozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> s��a�� o�rm�t <br /> Date Received � Phone Contad for Pertnittin e ? -- 7 �3 � <br /> �� I .�..- � � S ( <br /> OwnefsName r �� �`�Q � OwnerPhoneNumber 8�3' o�• �4 <br /> OwnersAddress 3�ai Nev1� O L r � IS �nerPhoneNumber <br /> Fee Simple 7itleholder Name �� f� ✓ Owner Phone Number <br /> Fee Simple TitleholderAddress <br /> JOB ADDRESS Af �� r(�rr 3.�J S LO7 # 0 4 5 <br /> SUBDIVISION �f �� �15 PARCELIDO 3 ' �5' � ' <br /> �aera�o Flta� AearEnr 7nx Nonc�l <br /> WORK PROPOSm e NEW CONSTR e ADDIALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK 7 I C� I S'n / <br /> BUILqNG SIZE S SQ FOOTAGE I H�GHT � �� <br /> �gUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY � W.R.E.C. <br /> QPLUMBING $ }� 1 f � <br /> n) U`' L/ <br /> QMECHANICAL $ VALUATIONOFMECHANICALINSTALLATION ' � , I `�� <br /> GAS ROOFING SPECIALTY OTHER ` <br /> 0 0 � o �� .�- <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �� ��- <br /> \ c `/ � /— � <br /> BUILDER ` COMPANY ��,�/)�e� �y ie,� �v7�� � <br /> SIGNATURE REp5TERED Y/ N FEE CURREN Y N � <br /> Address License # <br /> ELECTR�CIAN COMPANY <br /> SIGNATURE REqSTERED Y! N FEECURREN Y/N <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REqsiERED Y! N FEECURREN Y/N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REqsiERED Y/ N FEE WRREN Y J N <br /> Adtlress License # <br /> OTHER COMPANY <br /> SIGNATURE RE(�5fERED Y! N FEE CURREN Y/ N <br /> Address License # <br /> 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 <br /> RESIDENTIAL Attach (� Plot Phans, (2) sets of Building Plans; (1) set d Energy Forms; R-O-W Permd for new conshuction, <br /> Minimum ten (10) w,orking days after submMal date. Required onsite, Construdion Plans, Stormwater Plans wl Slt Fence installed, <br /> Sanihary Fxilities & 1 dumpster; SiDe Work Pertnd far subdivisiorWlarge projects <br /> COMMERCIAL Attach (3) complete sets of Bwlding Plans plus a Life Safery Page; (1) set of Energy Forms. R-O-W Permd for ncw mnstrudion <br /> Minimum ten (10) v.orking days after submi[tal date. Required onsite, Construdion Plans, Storrcrvvater Plans wJ SiR Fence installed, <br /> Sanitary FaciliGes & 1 dumpster. Site Work Pertni[ for all new projeds. All commercial requiremerds must rtieet compliance <br /> SIGN PERMIT Attach (� sets of Engineered Plans. <br /> '"*'PROPERTY SURVEY required for all NEW construction. <br /> D�rections: • <br /> Fill out appi�cation completely. <br /> Owner & ConMador sign badc d appication, notar¢ed <br /> If over t2500, a Notice of Commencement is requiretl. (AIC upgrades over 57500) <br /> "* Agent (fa the contrac[or) or PoNer of Attomey (for the w�ner) �nould be wmeone v�ith notar¢ed letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front oF Application Only) <br /> Reroofs if shirgles Se✓Yers Senice Upgrades A/C Fences (Pbt/Survey/Faahage) <br /> Driveways-Not wer Counter rf on public road�✓ays..needs ROW <br />