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a�s-7ao-oozo City of Zephyrhills Permit Applicatian Fax-813-780-0021 <br /> Building Department 2/ <br /> Date Received .�, .. � phone Contact for Permitting ��7 �76 -- 3�• �% <br /> Owner's Name Q �'1��ZC/ � ` vl Owner Phone Number ��3"377'—�� <br /> Owner's Address �Qx /��o �� � r� �-- Owner Phone Number � � <br /> Fee Simple Titleholder Name Owner Phone Number[ <br /> Fee 5imple Titleholder Address � <br /> JOB ADDRESS J/���� � U� LOT# `< z. <br /> SUBDIVISION SUd/.5�.7�'���5, � PARCELID# �� a6�/-�3i� QOoaD� Q6.ZD <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT Q SIGN Q MOVE � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 0 SFR 0 COMM Q OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME � STEEL 0 OTHER <br /> DESCRIPTION OF WORK �CD ��,�t.q,o �OB/�, x �c� <br /> � <br /> BUILDING SIZE SQ FOOTAGE HEIGHT �� <br /> � BUILDING $ �y� r� VALUATION OF TOTAL CONSTRUCTION <br /> � ELECTRICAL $ � AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.0 <br /> 0 PLUMBING $ � � j 2 � g�'�G <br /> ] r <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION� [ ,��.�� <br /> �y ,� �� <br /> � GAS � ROOFING Q SPECIALTY � OTHER � � ���,f 3�t"� <br /> �C <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES �NO .� I 2��I�Z <br /> � <br /> BUILDER �� ��, COMPANY /�°c/Sj� �/' SL°i"• / 1"- �'� <br /> SIGNATURE `�' c '""� REGISTERED Y/ N FEE CURRENT Y/N <br /> Address /3 7�7 � ' t�i�. �6✓/�� 3���06 �icense# C,QC/2S�'/Gj <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> PLUMBER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# � <br /> OTHER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y 1 N <br /> Address License# � <br /> RESID�NTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum te�(10)working 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 fo�new construction. <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 commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "**PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC 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 Application Only) <br /> Re�oofs Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> �riveways-Not over Counter if on public roadways..needs ROW <br />