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813-780-0020 City of Zephyrhills Permit Application� f f(� Fax-813-780-0021 <br /> Building Department `�� � � <br /> Date Received � -� � � Phone Contact for Permitting t�t � � � / -- <br /> �. h1 $� ' — � <br /> Owner's Name r V� � �- �� Owner Phone Number <br /> Owner's Address �� 1 G�� �`T� °/U � Owner Phone Number <br /> Fee Simple Titleholder Name j� I`� �1.� �-� ��� � 5 Owner Phone Number �(� �� � 7 y—��i 4� <br /> Fee Simple Titleholder Address � Q� L R E= � � D`L� J I <br /> JOB ADDRESS (0 Od 1`�tS j I� n' �7 LOT # S <br /> SUBDIVISION �IIi� � � � T � � � PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED �X NEW CONSTR e �ALT � SIGN 0 MOVE 0 DEMOLISH <br /> INSTALL R AIR � <br /> PROPOSED USE Q SFR 0 COMM � OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME Q STEEL � �THER <br /> DESCRIPTION OF WORK t%�C. �C..� !N`J1.'�-.'Q i ��'Z} ►' �i r - • � ��'! ���-•- �i �`�L.fI.I�"CY <br /> LQ t?tu� }� �.�. <br /> BUILDING SIZE �� X SQ FOOTAGE � HEIGHT D� �/� 10 X 1'S A <br /> C.t�int� �,tt <br /> BUILDING $ i.� _ VALUATION OF TOTAL CONSTRUCTION <br /> � AMP SERVICE PROGRESS ENERGY Q W.R.E.C. <br /> � ELECTRICAL $ 0 <br /> ��-- � ;� <br /> PLUMBING $ � � � - - '" ��i'"' <br /> C] �i \{�-__-_- -� 1 <br /> --�.-�--�---- - -'- <br /> � MECHANICAL $� VALUATION OF MECHANICAL INSTA ION � I�' C �_.� <br /> ;� �.� c� ( ���ar ..� <br /> � GAS � ROOFING � SPECIALTY 0 OTHER S� �;7�`�� <br /> FINISHED FLOOR ELEVATIONS (� FLOOD ZONE AREA �YES �td��----•--`"` � <br /> � <br /> BUILDER � t,Z; ,'�/ �. /Q � � COMPANY � <br /> „ SfGNATURE � REGISTERED Y/ N FEE CURRENT Y/ N <br /> C �_ � <br /> Address License # <br /> ELECTRICIAN <br /> �� � COMPANY C/ <br /> SIGNATURE S REGISTERED / CURRENT Y/ N <br /> Address License # � <br /> PLUMBER 1 COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRENT Y/ N <br /> Address License # <br /> MECHANICAL � � � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> OTHER �� COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � <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 Permit for new construction. <br /> .. _ . .. ---- --._..._.__ n�,........i e�i+ Co.,no incr�llcrl <br />