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8��-�e°-°°2° City of Zephyrhills Permit Application FaX����eo-0oz� <br /> , Building Department <br /> Date Receivad � 2/j 2— <br /> Phons Corkactfar <br /> Owners Name C.r( lx n �A o Owner Phone Number () V/ –1,� '�� <br /> Ow�s Md�sss � �W I�L�h ��. Owner Phone Number (J� J�LS/�� ,J�� I <br /> Fee Slmple Tltleholder Name Owner Phone Number �� <br /> Fae Slmple Titleholder Address � <br /> JOB ADDRESS ��� �� rh��l �� ,�h� `y L LOT A [I I ��� <br /> SUBDMSION ��WIr�S �'��S/ /ld(f�7��'� pARCE1W 1`I-zIv-ZI -l�►D -v0y(�-- �� �� <br /> (OSTAIIED FROM PI20PERTr TAx NOTICE) <br /> WORK PROPOSED � NEW CON57R B ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION B�OCK Q FRAME � STEEL � �/�� <br /> DESCRIPTION OF WORK �l f'IC (�{ "`"1 Q } ��G7')('�.e t s a,b Y�- � <br /> BUILDING SIZE �l X SQ PDOT/YG��� HEIGHT � � �' <br /> �BUILDING $ I _C� VALUATION OF TOTAL CONSTRUCTION <br /> �� .,] <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION T` t� �`� � <br /> QGAS Q ROOFING � SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER ��n� ` �, / COMPANY v-m e r�w�e r � <br /> SIGNATURE � � RECisrer�p Y/N F�cu�� Y/N <br /> Address —� <br /> license# <br /> ELECTRICIAN � � COMPANY � <br /> SIGNATURE r�cisrea�o Y/ N F�cuw�n Y/N <br /> Address License# _� <br /> PLUMBER COMPANY � <br /> SIGNATURE REGISTERED Y!N F�cuwt�n Y/N <br /> Addross License# � <br /> MECHANICAL COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address � <br /> License# <br /> OTHER COMPANY <br /> SIGNATURE �c�sre�o Y/N F�cuw�n Y!N <br /> Addrosa License# � _� <br /> IIIIIIIIIIIIII1111111111111111111111111111111 / 11 � 111 � 11111111111111 <br /> �IL Attach(2)Plot Plans;(2)sets of Building Plare;(1)set of Enerpy Fwms;R-0-W Permk for new construction, <br /> Minimum ten(10)working days atter submittal date. Required onsRe,ConsWction plans,Stormwater Plans w!Silt Femce installed, <br /> Sanitary Faalities 8 1 dumpster;Site Wak Pertnk for subdivisior�s/large projects <br /> COMMERCIAL Attach(3)complete sets of BuUding Plans ptus a life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new consWdion. <br /> Minimum ten(10)working days after submittal date. Requi�ed o�site,Construction Plans,Stortnweter Pfans w!Silt Fence installed, <br /> Sanitary Faci6Ues 8 1 dumpster Site Work Permit(or all new projects.All commercial requirements must meet compliance <br /> SICaN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Dineda�s. � � 1 � 1 � �i.li�ii. <br /> Fill out appHcation completely <br /> Owner&Contractor sign back of applica[bn,notarized <br /> If over f2S00,a Notice ot Commsnumant Is requlwd. (AIC upyradss over 57500) <br /> " Agent(for the contractor)or Power of Attomey(fw the owner)woukJ be someone wfM notarized Ietter from owner authorizing same <br /> OVER THE COUNTER PERM(TT1NG (FroM of Applioatlun prry) <br /> Reroofs'rf shingles Sewers Service Up�ades AIC Fences(PbUSurvey/Footage) <br /> Drlvaways-Not over Counter'rf on publk roadways..needs ROW <br />