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� ati�-�eo-oo2o City of Zephyrhills Permit ApplicaGon Fax-813-'8Q-0021 <br /> Buftding Departrnent <br /> Date Received � ' Phone Contact for Pem�iGi ��� �O` - �`J <br /> Owners Name (�/�1., Owner Phone Number p .7' lJ ��� <br /> Owner's Address Owne�Phona Number � <br /> Fee Simple Titleholder Name � ��er F'hona Number � <br /> Fee Simple TiNeholder Addmss � <br /> JOB ADDRESS S O � I VP� ��I i�� LOT S C� <br /> SUBDIVISION PARCEL IDB J/�'�K���'+oO�v � / KJ�D <br /> (OBTAINED FROM PROPER7Y TAX NOTICE) <br /> WORK PROPOSED e NEW CONS7R� ADO/ALT Q SIGN O Q DEMO�IfiH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER � <br /> TYPE OF CONSTRUCTION Q BLOCK Q fRAME � STEEL Q �-� <br /> DESCRIPTION OF WORK �/� li��'/�J�{�'''DLL � W,"��/V e� � <br /> BUILDING SIZE SU FOOTA6E� HEIGHT � <br /> OBUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> �EIECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUM8ING $ <br /> �MECHANICAL $ +�� VALUATION OF MECHAN�CAL INSTALLATION <br /> ✓ <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY � <br /> SIGNATURE REGISTERED Y/ N �cufiRen Y/N <br /> Address License# __ � <br /> ELECTRICIAN COMPANY � <br /> SIGNATURE REGISTERED Y! N FEECURRE� Y!N <br /> Address License il � <br /> PLUMBER COMPANY � <br /> SIGNATURE REGISTERED Y/N c�cuwxen Y/N <br /> Address ticense# � <br /> MECHANICAL ~ COMPANY AH/E�'S !'�PA�Je t�/C-T� <br /> SIGNATURE feEGiSrErt� Y/ N FEE CURRE� Y/N <br /> Addresa � � License k l C./7'C.� T a�� <br /> OTHER COMPANY <br /> SIGNATURE �GiS�D Y/N FEE CURRE� Y/N <br /> Address License# _� <br /> RESiDENTIAL Attach(2)Pbt Plans;(2)sets of Buiiding Plans;(1)set of Enetgy Forms;R-O-W Permit for new w�SWcUon. <br /> Minimum ten(t0)working days after submitfal date. Required onstte,Consiructlon Plans,Slormwater Plans wl Silt Fence Instaiied. <br /> Sanitary Fadlides&1 dumpster;Ske Work Pertnit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)camplete seb of BWlding Plans plus a LHe Satety Page;(1)set of Energy Forms.R-O-W Permit for new construcGon. <br /> MiMmum ten(10)working days after submitfal date. ReqWred aisite,CansWctlon Plans,Stormvrater Plans w!Silt Fence installed, <br /> Sanitary Fadlitles d t dunpster.Site Work Pertnit for all new pr�ects.PJI commerdal requirements musf ineet compBance <br /> SIGN PERMt7 Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY requred for aN NEW constructfon. <br /> Directfons: <br /> Fi11 out appicatlon completely. <br /> Ovmer 8 Contractor sign back of applicatbn,nMarized <br /> H over Y2500,a NoNce of CommencemeM Is raquired. (A/C�pgrades over t7500) <br /> " Agent(for the coMractor)or Power of Attomey(for the owner)would be someone with noharized IeUer from owner auC�orizing same <br /> OVER THE COUNTER PERMI7TING (Front of Applicatlon Only) <br /> Reroofs if shi�gles Sewers Service Up9rades A/C Fences(PbUSurvey/footage) <br /> Driveways-Not over Counler K on public roadways..naeds ROW <br /> b001Z00 d £EC# sb o� ��ozro��so �o�� <br />