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s�3-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 �,,, <br /> /- Building Department <br /> ' 9 �13 �76 -- y3-�6- <br /> Date Received ��'� -- � phone Contact for Permittin <br /> Owner's Name � U7��Cl�✓"' Owner Phone Number �(5.3 (�Z- O O <br /> Owner's Address ��o VS /� r„� �i'�`G�p' �2 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address hi� � <br /> JOB ADDRESS � �� O ,�t� ��° � /j i� � � ,3•�� LOT# � <br /> SUBDIVISION �/t� ��� PARCEL ID#�U�26-2I-D// -. C90dd G — 00,� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT Q SIGN � MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME Q STEEL Q OTHER <br /> DESCRIPTION OF WORK /�'c � � O/"' / x � �` � ���5� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> BUILDING ($ h -� VALUATION OF TOTAL CONSTRUCTION � ��� v� <br /> � �2S <br /> � ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.0 <br /> 0 PLUMBING �$ � /�/� <br /> � � �v <br /> � MECHANICAL � � VALUATION OF MECHANICAL INSTALLATION <br /> C��-� ' � <br /> � GAS � ROOFING � SPECIALTY Q OTHER -�.� <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES QNO vR� ����"` <br /> � (2 <br /> BUILDER _ _- � COMPANY /�'��A�v ,�'XX'..S�e/'�'�Z'P C�'�1�3 <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address � � JL�O�Ie /GC/�C��✓�` � License# G/��s��'63 <br /> .�.�762 <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/N <br /> Address License# � <br /> RESID�NTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fo�ms;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 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,Construc6on 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. (A!C 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 /> Reroofs Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />