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' 813-780-0020 , <br /> City of Zephyrhills Permit Application � <{ <br /> , Building Department ax-813-780-Q�;,� <br /> Date Received <br /> 1 /3 Za� Z <br /> Phone Cantact for Permittln ��3 ��� I <br /> Owner's Name _ -� p —7 ' <br /> ° 5 � ,�e� � - ; <br /> OW�er's Address wner hone Number "7 Z � <br /> p H �M� � S'3`� �0 9 y- <br /> , � -----__ <br /> Owner Phone Number ��'' <br /> Fee Simple Titleholder Name � <br /> �L._ <br /> Owner Phone Number —r-- <br /> Fee Simple T(tleholderAddress <br /> JOB ADDRESS /� ' <br /> �� Y� l�Nl4NC6-yi �fl �' �j ----._:_ , <br /> SUBDIVISION � LOT' � ' <br /> � PARCEL ID# I�-Z�n"2Z- p v�� - G>c�(p �'- - <br /> WORK PROPpSED e 0 0�7� <br /> NEW CONSTR;� (OBTAINED FROM PROPERTY 7AX NOTICE) �"'-'— <br /> INSTALL � REPAIRT � SIGN � <br /> PROPOSED USE 0 ' :MOLISH I <br /> TYPE OF CONSTRUCTION � SFR � COMM � <br /> C� BLOCk OTHER �------_. _� ,__ <br /> C� FRAME �� STEEL � <br /> DESCRIPTION OF —! --�' <br /> WORK +�IST�q�� �,�W <br /> U�.�T�-�t Secue�ry SYsre„n tN �- -----!— <br /> ---____ <br /> BUILDING SIZE ��Sr�!N_Ej��Sr►�i;5s <br /> gr� `UOTAGE� ------._� <br /> �-----J HEIGHT [—_� i <br /> �BUILDING $ � <br /> VALUATION OF TOTAL CONSTRUCTION I <br /> �ELECTRICAL $ ^� <br /> � 'J�� AM�SERVICE � PROGRESS ENERGY , <br /> �PLUMBING f i <br /> $ � W.R.�.t, <br /> C�MECHANICAL $ � <br /> VALUATION�F MECHANICAL INSTALLATION <br /> I <br /> �GAS � ROOFING <br /> FINISHED FLOOR ELEVATIONS � SPECIALTY C7 OTHER � <br /> i <br /> FLOOD ZONE AREA <br /> �YES N0� I <br /> BUILDER � <br /> SIGNATURE ' ��1-hHittt+ <br /> COMPANY �'—- —�-! <br /> REGISTERED � <br /> Add�e55 , Y� N FEE CURRE� I <br /> Y/! �--� <br /> ELECTRICIAN License# C ��—; <br /> SIGNqTURE <br /> i <br /> COMPANY �'— --� <br /> Addl'eS3 REGISTERED Y/ N <br /> FEE CURRE� <br /> Y i t_]--- ' <br /> PLUMBER License# C — ' <br /> SIGNATURE --__ <br /> COMPANY — —�-' <br /> ----�. - <br /> Addf2SS REGISTERED Y/ N <br /> FEE CURRE� Y/�, -)---�.' <br /> MECHAN�Cq� License# C --- I <br /> SIGNATURE —___., �` <br /> COMPANY — -----._ <br /> Add�BSS REGISTEREO Y� N <br /> FEE CURRE� <br /> Y�t �-- ; <br /> OTHER � License# C—_i—�- <br /> SIGNATU - _G5' � f�1�T S CuY21T�( — �;__ <br /> � �'T� COMPANY <br /> Address Sc�']r U , f p REGISTERED Y N <br /> W���5 n�r T14MP14 FL �(p� FEE CURRE� Y/i <br /> RESIDENTIAL Attach(2)Plot Plans; License# �F' ��O 23` <br /> Minimum ten(10)work n,g days after submittai dafe. Re � <br /> ( )set of Energy Forms;R-O-W permit for new construction, �� <br /> COMMERCIA� S�niiary r=acilities& 1 dumpster;Site Work Permit for subdivisions/large projects <br /> quired onsite, Construction Plans,Stormwater Pl�ns w/ .ilt Fence insta l� <br /> Attach(3)complete sets of Building P�ans plus a Life Safet Pa e; <br /> Minimum ten(10)workin da s y 9 (1)set of Ener <br /> 9 Y aher submittal date. Required onsite,Construction Plans,Stormwater Plans w/ .�It Fence in <br /> SIGN PERMIT Sanitary Facilities& 1 dumpster.Site Work Permit for all new proJects.All commercial re uir <br /> Attach(2)sets of Engineered Plans. 9Y Forms.R-O-W Permit for r� constructionl <br /> "'"PROPERTY SURVEY required for all NEW construction. staii <br /> q ements must meet� �mpliance <br /> Directions; I <br /> Fill out app�ication completely, <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,a �I- <br /> Notice of Commencement Is required. I <br />�� Agent(for the contractor)or Power of Attome (aC upgrades over E7500) J <br />�VER THE COUNTER PERMITTING y(for the owner)would be someone with notarized letter from owner authorizin I <br />�eroofs if shingles Sewers (Front of App�ication Only) � <br /> Service Upgrades aC 9' me i <br /> Driveways-Not over Counter lf on public roadways..needs ROyy nces(Plof/Survey/Footage) <br /> I <br /> � <br />