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sis-�ao-oozo City of Zephyrhills Permit Application Fax-813-780-0021 ;� <br /> Building Department <br /> Date Received � +� � "1'7� �/ _ �/ �C �� <br /> Phona ConWct for Pennittin /O� (C� ..� <br /> Owner's Name � �-e �'� N��'� � � � Owner Phone Number �� c 7 �' `, � ' <br /> Owners Addresa /Ui� �V G N n UM (.., Ownar Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOBADDRESS � I/V/� NC�U�/U�/i � ZP�I� ( I�IUS �C�3 7Sy LOT# � <br /> SUBDIVISION G r��� /{�/'/ZU,�/5 pqRCELID# � ',��- J - - UL�U -'U�`l I <br /> � /� U�e (OBTAINED FROM FROPERTYTA7C NOTICE� <br /> WORK PROPOSED � � NEW CONSTR B ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK //✓5 TU��L l�) �G CU�1�/U!J S�//�C�/�S,(��CI����F� �N��IC �� 5����G,✓ <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT �� �l�O(I ) Cl�!/"l?f(F� <br /> ������� � - - � ����� - - - � �.i� � � - - � � - � � �—�.�.....� HGfI�I�IC1�r'`� <br /> L <br /> �UILDING $ �O,� VALUATION OF TOTAL CONSTRUCTION SL��/r /�DO(�-- <br /> ��ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � ���., i /'? <br /> !l(�7 <br /> ��MECHAMICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> 1 1 i 1 4�`.1 � 1 � i � 1 �.i.d..L�� � ' 1 i ' I�..e�......�1 1 1 I..�w� <br /> BUILDER ��y/ �Q �COMPANY �U!�-��/7 I�C�/-�/ L L�,. <br /> SIGf�ATURF "� '6 RE31STEkcD �/ N � FFF CURRE� Y i N <br /> Address �/ /G��/2 �[�/2lq,y� �� FL. ucer.se# ;CGC i Sr 3�d � i <br /> ELECTRICIAN C MPANY � <br /> SIGNATURE REGISTEREO Y/ N FEE CURRE� Y/N <br /> Address ----- — !icense� �------� <br /> PLUMBEF �— � COMPANY _, <br /> SIGNATU�E Fe��srer:EO Y! N ee�u-==r. t"/N <br /> Address � License# � <br /> MECHANICAL COMPANY <br /> SIGNATURE RECaISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-0-W Pertnit for new construction, <br /> Minimum ten(10)working days aRer submittal date. Required onske,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliGes&1 dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERCL4L Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submiKal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumps[er 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 /> 1 1 � � � � � 1 1 1 � � � 1 � � � � � � 1 1 � � � 1 � 1 � 1 � 1 � 1 1 1 1 1 � � � � � � � 1 1 1 � 1 � � <br /> Directlons: <br /> Fill out application completely. <br /> Owner&CanVactor sign back of application,notarized <br /> H over 52500,a NoNce of Commaneement is requlred. (A/C upgndes over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone wilh notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs'rf shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />