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� 8�3-780-0020 Ciry of Zephyrhills Permit Application Fax-ais-�ao-oozi
<br /> Bwlding Department - ,
<br /> Date Recerved /� � /I� ) '] 7
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<br /> Pho Ct for Permi i �
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<br /> Owners Name �A f}/1/ � Owner Phone Number �'� T J U' / �
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<br /> Owner's Address �!Jv r f�' S Owner Phone Number ��
<br /> Fee Simple Titleholder Name Owner Phone Number ��
<br /> Fee Smple Titleholder Address �
<br /> JOB ADDRESS (� I �1/UPi� O� "� �� LOT# /�
<br /> SUBDIVISION Sjjve� �A�/V /"�s�" /A PARCELID# �y��"'a�r��'V�p[/g� ��Q(l��')'���v{,i
<br /> (08TAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e NSTALONSTR e R�EPAIRT � SIGN � MOVE � DEMOLISH
<br /> PROPOSED USE �� SFR � COMM � OTHER --�
<br /> TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL � OTHER�--�
<br /> DESCRIPTION OF WORK � � � r Q� I N (,°� �
<br /> BUILDING SIZE SQ FOOTAGE HEIGNT
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<br /> �� BUILDING $ �I ?a'] VALUATION OF TOTAL CONSTRUCTION
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<br /> � EIEGTRICAL � AMP SERVICE � PROGRESS ENERGY�. � W R.E C
<br /> � PLUMBING $ ��/
<br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � �I��
<br /> � GAS � ROOFWG � SPECIALTY � OTHER �
<br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA �YES �NO -
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<br /> BUILDER COMPANY / � /gt �('fM� S�Y'V/CCS
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Atldress � G� �/1� �/1 T �L 7��n License# � �� �
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Add�ess License# ��
<br /> PLUMBER � COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEECURRENT Y/�
<br /> Add�OSS License# ��
<br /> MECHANICAL� � COMPANY �_
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N �
<br /> Address License# ��
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEECURRENT Y/N
<br /> Address License# ��
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<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms
<br /> Minimum ten(10)wnrking days after submittal date. Required onsite,Construdion Plans,Sanrtary Facilities&1 dumpster
<br /> COMMERCIAL Attach(3)sets of Building Plans,(1)set of Energy Forms.
<br /> Minimum ten(10)�.wrWng days after su6mittal date. Required onsde,Construdion Plans,Sandary Facilities 8 1 dumpster
<br /> All commeraal reqwrements must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans
<br /> ""PROPERTY SURVEY requved for all NEW construdion
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<br /> Fill out application completely
<br /> Owner 8 Contractor sgn back of apphcation,notarized
<br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$5000)
<br /> " Agent(for the coMractor)or Power of Attorney(for the owner)would be someone with notar¢ed letter from owner author¢ing same
<br /> OVER THE COUNTER PERMITTING (Front of Application Only)
<br /> Reroofs Sewers Sernce Upgrades A/C Fences(PIoVSurvey/Footage)
<br /> Drrveways-Noi over Counter rf on pubhc roadways needs ROW
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