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d,s-�du-uuzu City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department �,�i ( ���� <br /> �1 � � <br /> Date Received �(�'� 7/ Phone Contact for Permittin `�1 3 `7�� __�o S 3 <br /> Owner's Name , �� �.L. ,Q N,4 %ll Owner Phone Number <br /> Owner's Address ?S�oZ�' ��iC I�-a.-.�. Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Addroas <br /> JOB ADDRESS �ca� I�� , �h�,�Q�j LOT� �� <br /> --� <br /> SUBDNISION PARCEL IDN O�- ' - - Of� -G�O � -- O� O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NVORK PROPOSED e NEW CONSTR� ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM [_] OTHER <br /> TYPE OF CONSTRUCTIOM BIOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK /L( <br /> BUILDING SIZE SQ FOOTAGE - --------- <br /> 0 BUILDING S VA ATI OF TOTAL CONSTRUCTION 7v�� �— <br /> QELECTRICAL a AMP RVICE Q PROGRESS ENERGY W.R.E.C. <br /> ----- _--.____—_ <br /> QPLUMBING a <br /> ��� � � <br /> QMECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER � z`�� P��� <br /> ✓ <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NC(�-Ati��- ��� <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# i� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas license# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address -i License# —� <br /> . <br /> OTHER � COMPANY <br /> SIGNATURE 1,.� ( D NC � � � � REGISTERED Y/ N FEE CURRE� Y/N <br /> Addross 3 J�� /"�o o t'�'Z ,� �c�e_ License# CC C-�57�y 2 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)seta of Bullding Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FadllUes d�1 dumpster;Site Work Permit for subdivisions/large proJects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a LHe Safety Page;(1)set of Energy Forms.R-O-W Permit for new conshuction. <br /> Minimum ten(10)working days after submfttal date. Required onsite,Construction Plans.Stonnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Woric Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "•'•PROPERTY SURVEY required tor all NEW consVucdon. <br /> Directiona: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of applicatlon,nota►ized <br /> If over 52500,a Notice of Commencement Is requfred. (AIC upgradas over t7500) <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 PERMITTING (Front of Applicat�o�Only) � <br /> Reroois if shingles Sewers Service Upgrades A/O Fences(PIotJSurvey/Footage) <br /> Drivewaya-Not over Counter if on publtc toadways..needs ROW <br />