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si3-�eo-oo2o City of Zephyrhills Permit Applicati fl !' Fax-81&780-0027 <br /> Building Department �� <br /> .�5 <br /> )ate Reeelved �� � q Phone Cor�tact for Pertnitd (} � — U7�.�J <br /> �wner's Name r� m�t5 L-� J� 1`rv�5+ Owner Phons Numbsr �� 3 ' — 78 3 ��-�o <br /> �wners Addmss � 7 ��l � �7 7'/eP� Owner Phone Number <br /> °ee Simple Tkleholder Name Owner Phone Number <br /> �ee Sfmple Titleholder Address <br /> JOB ADDRESS �� � (� � 5 �" LOT / � <br /> SUBDIVISION PARCEL IDM I —� � '� � G � f U — �, f} �-�Ji7 — CJU [ou <br /> (OBTAINED FltOM PROPERTY TA% NOTIC� <br /> WORK PROPOSED B NEW CONSTR B ADD/ALT �J SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE �i SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION a�/ � BLOCK Q F Q STEEL Q <br /> DESCRIPTION OF WORK M�'��� '� ( V u ��� Q��'''� �Q�''� <br /> BUILDING SIZE �V + X�� �(/ ,� SQ FOOTAGE �$� HEIGHT �, <br /> �BUILDING E�D vO� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL a AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. ��'� <br /> s $� �i��c r � , . �, Z �� <br /> QPLUMBING S r G� -� �'�_ S��i' ��i.S'%Z <br /> � � G .��. � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ',�`" �� <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER � �/ 7� G� <br /> FINISHED FLOOR EIEVATIONS FLOOD ZONE AREA QYES NO F� 3 <br /> � <br /> BUILDER � COMPANY �UC, �I�"�"� � ��^5'��t �a-� Z <br /> SIGNATURE REGISTERED Y! N �E WrtaE� Y/ N <br /> Addross 3 2 y � G l�n I�a� LJcense #��ViT � 2U (oFJ� <br /> �CTRICUIN �����;J;�/[�`� '� COMPANY � <br /> SIGNATURE �' � ��y� REGISTERED Y/ N FEE CURREA Y/ N <br /> Addross License # � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CuRREn Y/ N <br /> Address License # <br /> y , � --�_ <br /> C NICAL� �� COMPANY <br /> IGNATURE REGISTERED Y/ N FEE CURRE�. Y/ N <br /> k.-� ba�K�' <br /> Address �icense # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CufiREn Y! N <br /> Address Llcense # <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of BuiMing Plans; (1) set ot Energy Fortns; R-O-W Pertnit for new ow�structlon, <br /> Minimum ten (10) working days after submiltal date. Required onsite, Constructlon Plans, Stortnwater Plans w/ Silt Fence installed, <br /> Sanitary Fadlitles & 1 dumpst�, Site Work Permit for subdivislonsllarge projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-0.W Permit for new consWctlon. <br /> Minimum ten (70) working days afler submittal date. Required onsite, Constructlon Plans, Stormwater Plans w1 Silt Fence installed, <br /> Sanitary FaaBtles & 1 dumpster Sife Work Permit for all new projects. All commerdal requiremenfs must meet compliance <br /> SIGN PERMIT Atfach (2) sets oF Engi�eered Plans. <br /> "'•PROPERTY SURVEY required for all NEW construction. <br /> Direclions: <br /> Fill out application completety. <br /> Ovmer & Contractw sign back of applicatlon, notarized <br /> I( over 52500, a Notice of Commeneement Is requlred. (AIC upgrades ovar i7500) <br /> "' Agenl (for the conVaclor) or Power of Altomey (for the o�nmer) would be someone with notarized letter (rom ownar authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicatlon Only) <br /> Reraafs i( shingles Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />