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n,s-rdu-uuzu City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date�ecetved <br /> Phone Contact for Permittin (�, " �� .- SS� <br /> Owner's Name L` 11� Owner Phone Number � � � _ — � � <br /> O�nmer's Address � �� � `� Zc , <br /> 3 5 I Owner Phone Number l - �I 3 -7�13 -���'j � <br /> Fee Simple Titlehoider Name Owner Phone Number � <br /> Fee Simple Titieholder Addroas <br /> JOB ADDRESS �'5��1 E C�vY��, �--iy c LOT A� � <br /> SUBDIVISION PARCEL ID#� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> MVORK PROPOSED NEW CONSTR ADD/ALT [—� SIGN Q � DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME [_] STEEL Q <br /> DESCRIPTION OF WORK tl�/�l�ll� C' �1f,�!NESS C�c..��g (,� o NS VI2 Q� <br /> BUILDIN(i SIZE SQ FOOTAt3E � O HEI(iHT <br /> QBUILDING S l VALUATION OF TOTAL CON�CTION � ��'`�' 0� 1� <br /> QELECTRICAL a AMP SERVICE Q PROGRESS ENERGY <br /> Q W.R.E.0 <br /> QPLUMBING a <br /> � (�353 / <br /> OMECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD 20NE AREA QYES NO <br /> BUILDER �r� COMPANY ��� C�{v — Lc c�i . <br /> SIGNATURE REGISTERED Y/ N FEE CURREI� Y/N <br /> Addreas vZ50 � �l�o(d(,4;v� �I� U��p � License# ��C Q�o �/•�9 q � <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 /> IIIIECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y!N <br /> Addreas License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-0-W Permit for new const►uction, <br /> Minimum ten(10)worlcing days aiter submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles d�1 dumpster;Site WoNc Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Buflding Plans plus a Lffe 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,Constructfon Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles 8 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 fa all NEW consUucdon. <br /> Directlons: <br /> Fill out application wmpletely. <br /> Ovmer 8 Contractor sign badc of applicatlon,notaNzed <br /> If over S2S00,a Notice of Commencement Is roqulred. (AJC upgradas over i7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter irom owner authorizing same <br /> OVER THE COUNTER PERMI7TING (Front of Applicatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Drf�ewaya+Npt ove[Counter if on,pdWfc rohdways..needs ROW " "'"" ' ' ' �� �� � �'�-�°-�_ <br /> � ` <br /> i <br /> r + , <br /> � - <br /> } a <br /> � . < . <br /> �:,,,-... _ , ._ . � �..�. .... . ,. ... . . �...,.a...� <br />