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s�s-�ao-oozo City of Zephyrhills Permit Appiication Fax-813-780-0021 <br /> Building Department <br /> �� �l3 �- ��- ��3z �pz� <br /> Date Received "'�� Phone Contact for Permittin � � � ���^74 ��� <br /> Owner's Name � q A � f10N Owner Phone Number <br /> Owner's Address ��7 J 3 r /7!�� Z � ����I� � 3 �ZOwner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOBADDRESS ��� � 3 r� /`t'V' ZC � �����5 33.s�f2 LOT# � <br /> SUBDIVISION � PARCEL ID# �� Z`b U (�/I? 1�'fr0l� Uj2 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK � �OS� ) 1'� (,: G� r ..Dr"{" _ �'%q�r,e G✓q;+� ' — j lt l�h,y �?r?f' -('�/e/'�e� Qr' <br /> BUILDING SIZE � SQ FOOTAGE� HEIGHT � I.✓6{��S U���`� C � W A ,� <br /> G�r�,•h <br /> OBUILDING $ ���/� '� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP S VICE Q OGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ! �_----�� I �"V�� <br /> � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS [� ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> ` F���i�5 � E��S ��- <br /> BUILDER MPANY <br /> SIGNATURE �� � REGISTERED Y/ N ' FEE CURRE� Y/N <br /> Address License# ,�C� 0���73 / � <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> Address License# � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> RESIDENTIAL 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 aRer submittal date. Required onsite,ConsUuction Plans,Stormwater Plans w/Sitt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Buildfng Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcUon. <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 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 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (AIC upgrades over ET500) <br /> "' Agent(for the conVactor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> "a �UVER THE CAUNTER REI�MITTING (Front of Application Only) <br /> �� Reroofs if shingles Sewers Service Upgrades AIC Fences(PIoUSurvey/Footage) <br /> Drivbways-Not tiver Counter if on public roadways..needs ROW <br />