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sis-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received� �� 5 �I� � � � g�3 <br /> � Phone Contact for Permittin <br /> Owner's Name � t T'b � � Z� � 5 Owner Phone Number �-��� - `77� ��((� <br /> Owner's Address �C7�J 6 G A` L,�Q� � �{ 3 < Ow�er Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �O S C��A\� �(�1� LOT# � <br /> SUBDIVISION PARCEL iD# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT �_] SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER �} �� W� S <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK R� � �� -- � � �.(�`�S '� _ ��.� � <br /> BUILDING 51ZE �— '$Q FOOTAGE� H�IGHT <br /> OBUILDING E VALUATION OF TOTAL CONSTRUCTION �`��j ��(`) c� <br /> ��r � <br /> QELECTRICAL $ + � OQO AMP SERVICE Q PROGRESS ENERGY �] W.R.E.C. <br /> OPLUMBING a �(3L��� <br /> O6 <br /> QMECHANICAL $ �� C� VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER r4 � - �'} � ��c�pC,� �v�S�'���,c7� <br /> SIGNATURE `�-�- � f\ �j CO PANY <br /> � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �, �iy� {� I.XL �= License# C V�Q < �p <br /> ELECTRICIAN �COIIAPANY ��( ���i�.L� I" �- `^��� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N �j � <br /> Address 'V�� License# �jU�Z� � � <br />� PLUMBER �� ��� '��y COMPANY �OAS���- V���A�1 tC�.i� � <br /> SIGNATU REGISTERED Y/ N FEE CURRE� Y/N L�-�6- <br /> D,y ��ddriess . �(}� , C C Z/. /� <br />'t c�P�� � Lic�ns�� � 1 lD tP 6 <br /> MECHANICAL COMPANY �`�S}'��-- ���L�`�N �G4(� �. � <br />� SIGNATURE ��' � ���y � <br /> REGISTERED Y/ N FEE CURRE� Y/N � <br /> Address License# �"l�'T-� �(�7�- <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTtAL 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)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence instalied, <br /> Sanitary Facilitles 8 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 constnaction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for all new projects.All commerclal requirements must meet compliance <br /> SIGN PERMiT Attach(2)sets of Engineered Plans. <br /> '""'PROPERTY SURVEY required for all NEW consVuction. <br /> Directlons: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a NoNce of Commencement is required. (A/C upgrades over 57500) <br /> "' Agent(for the contractor)or Power of Attomey(for the owner)would be someone wlth notarized letter from owner authorizing same <br /> OVER THE GQU.�ITER PERNJJTfI�I� r„� ,r(Front f Applicatlon Only) <br /> Reroofs if sMingles Sewers Servjce.IJpq�des A/C Fences(PIoUSurvey/F.oe�ge} -�»�-�-- - - ...w�... .,.§ <br /> � Y x t , .•�• �� <br /> Drivev�ays-Not over Counter if on publi��oad�rays..needs ROW � �� ° � • <br /> ` k...�-. i� ... w �.�,!.,+a�, �w• •A '� � r•,.�. �w.�.� . � ..u.v M.��t`+�� <br />