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s,��so-oo2o City of Zephyrhills Permit Application Fax-813-7 -00 �-_�e <br /> , Building Department j��� <br /> Date Received Phone Contact for Permitting - <br /> er's Name r � Owner Phone Number �� 3 `}7 - 5 y �� <br /> Owner's Address �,� �Z"�1 1 � Owner Phone Number C � <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address ' <br /> JOBADDRESS ����u'?f� Il� � ��-' � LOT# C� <br /> °UBDIVISION � PARCEL ID# `�- � ' 1- l��J- (�� �- JR-� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR � ADDlALT � SIGN Q MOVE � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR 0 COMM Q�OTHER 'RG-40� I <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL � OTHER <br /> DESCRIPTION OF WORK �5 11� { 1 � �,I��L`t'l .: �J %� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT �� <br /> �� BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> � ELECTRICAL �$ � AMP SERVICE � PROGRESS ENERGY Q W R.E.0 <br /> � <br /> � PLUMBING � � <br /> � MECHANICAL �$ � VALUATION OF MECHANICAL INSTALLATION <br /> � <br /> � GAS Q� ROOFING � SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES QNO <br /> BUILDER 1 � ��j� COMPANY 1�II� Uc� ) 1 l�l?�- l N c_ _ _ <br /> SIGNATURE E:��'v — REGISTERED I / N FEE CURR T Y N � <br /> Address ��"!�� U� �� �e G�1��) 3�� License# � ��j'``).�`�Z,. �,� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# f � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> � <br /> Address License# � <br /> MECHANICAL COMPANY <br /> iNATURE REGISTERED Y/ N FEE CURRFNT Y!N <br /> Address License# � <br /> OTHER COMPANY <br /> SItiNATURc I:cCI�TER�C Y/ �`� F5E CURP.ENT Y/N <br /> Address License# � <br /> BN�i� <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Eneryy Forms <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpsker <br /> COMMERCIAL Attach(3)sets of Building Plans,(1)set of Energy Forms. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpster <br /> All commercial requirements must meet compliance. <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> `*"'PROPERTY SURVEY required for all NEW construction. <br /> -�r pu!Idl�B <br /> rections: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application, notarized <br /> If over$2500,a Notice of Commencement is required. (A!C upgrades over$5000) <br /> '" Agent(for the contractor�or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of A�plication Only) r� <br /> Reroofs 6ewers Service Upgrade� A!C Fences(PIoUSurvey/Footage) �_f� ����' <br /> Driveways-Not over Counter if on public roadways. needs ROW <br /> ii'r <br />