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s�3-�eo-oozo �ity af Zephyrhills Permit Application Fax-813-780-0021 <br /> • Buiiding Department <br /> Date Received <br /> Phone Contact for Permittin _ <br /> Owner's Name � �--� � kL Owner Phone Number � 3 � ��..5� go13 <br /> Owner's Address 3 7 3 � 7 ���L �f� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3 73 I 7 � r �..�. !� 1/C_ <br /> LOT# 1 �7 ° <br /> SUBDIVISION ��� �U� l Z�'n�J , PARCEL ID# 3 4-�s a i-�r 4 v �p��� _ � ,��� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEw CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL EPA1 � <br /> PROPOSED USE Q SFR Q COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME [� STEEL Q <br /> �� t � ' <br /> DESCRIPTION OF WORK �'�, ��—� <br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT �� <br /> QBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE Q PROGRESS_�fQERGY Q W.R.E.C. <br /> /� <br /> QPLUMBING $ �� ��/ % <br /> ' r / <br /> l�� IMECHANICAL $ VALUATION OF MECHANICAL INSTALLATIO ���.--�- .--'� <br /> � �. �'d.D D .; <br /> QGAS Q ROOFfNG Q SPECIALTY [� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address ' License# � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL ,�� � p COMPANY � )� C D/IIIJ � ELE C <br /> SIGNATURE ��L� REGISTERED Y N FEE CURRE� Y/N <br /> Address �3 m Em v R�,qz .�.�.� License# �� C��3 9 7 S5' <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)woricing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constniction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities& 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""'*PROPERTY SURVEY required for all NEW constniction. <br /> Dlrectlons: <br /> Fill out application completely. , <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgrades over 57500) <br /> *' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> e ic Upgrades A/C Fences(Plot/Survey/Footage) <br /> NOc'JF:DAG�JJ�311�� <br /> �AiUfl��lpu�p�-l��nt i roadways..needs ROW <br /> itOS.0�4�cM tasiqit;.a�ni00�A!�• �� <br /> 014ief��r►r�+a�Nrenw3 r�. <br /> � �M1�4' ' �.. �� <br />