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- e�saao-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building DepaAment <br /> i Date Recelved �� phone ConWct(or Pertnitting �.3 �O sT — Q� <br /> � � � � 1 1 I 1 1 1 1 l 1 <br /> Owner's Name �/Y71� i'/� Owner Phone Number <br /> Owners Address Z / Ki9 /��A/� �{J(J Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Numbsr � <br /> Fee Simple Tkleholder Address � <br /> JOB ADDRESS �S � LOT 1f ��7 <br /> SUBDIVISION /i� OJl/ C F� PARCEL IDM 3 y-as-ai��/S���C%��-3�9D <br /> (OBTAINED FROM PROPERT'TA]I NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADDlALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRiPT10NOFWORK CVH/L GfLtNt�� C�/S77�1 C ��'�' L�L N/�Cq� TL% �7 <br /> BUILDING SIZE �� 3� SQ FOOTAGE �� HEIGHT � <br /> BUILDING $���y� � VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $�� L� AMP SERVICE Q PROGRESS ENERGY Q W.R.E C. <br /> QPLUMBING $ � �y} Y <br /> V <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �` � <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER .�(, �COMPANY N (:D�j7j2LCL•.'f�O� � <br /> SIGNATURE o REGISTERED Y/ N FEE CURRE� Y/N <br /> Address S� Y I Y� 1L License# C!DL:V�?�O c�+� <br /> ELECTRICIAN �COINPANY /��(i'e7Dh< G�C� � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 310 � G i� ��l�� License# �R BQ��S(v, I <br /> PLUMBER COMPANY � <br /> SIGNATURE REGISTFRED Y/ N FEE CURREI. Y/N <br /> �d�� License# � <br /> MECHANICAL COMPANY � <br /> SIGNATURE rtE�isr�o Y J N FEE CURREn Y/N <br /> Address License p � <br /> OTHER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURREh Y/N <br /> Address License# � <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIi1t111111111111ti111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)seLs of Building Plans,(1)set of Energy Forms;R-O-W Pertnit for new consWction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Faalities 8 1 dumpster;Ske Wak Permtl tor subdivisionsAarge projects <br /> COMMERCIAL Adach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new constniction. <br /> Minimum ten(10)working days after submittal date. Required onsile,Construction Plans,Stortnwater Plans w/Silt Fence instaUed, <br /> Sanitary Faalities&1 dumpster Site Work Permit for all new projects All canmercial requirements must meet compliance <br /> SIGN PERMIT Attacn(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW conslrudion. <br /> Directions:. <br /> Fill out application completely <br /> Owner 8 Contrector sign back of applip8on,nMarized <br /> If over 52500,a Notica of Commencement is required. (NC upgndes over E7500) <br /> " Agent(for the contrector)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIITING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgredes A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter'rf on public roadways needs ROW <br />