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$��-�5�20 City of Zephyrhills Permit Application Fax-813780-0021 <br /> eui�diog�epertmeM <br /> Date Received phone CoMact for Permitting - <br /> r_r r_T.T_7_r_r. _ -�-��_t_I. _ <br /> Owner's Name ��}�� ��'� R�'� �'s r•rr� P�r'��c s Owner Phone Number ��y, �y �- �'�y a <br /> Owner's Address �7 7 ,����'a��`J�' s�-K S, i¢f��,vr� (s/� Owner Phone Number � � <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS b'S S U �/ �i R � z�. �e,�l�//s 1 ,33�y� LOT�F � <br /> susoiv�siow }y/P�,� �1�i/,ts�� r srn-rx PARCEL ID# ���'2`S ZI -b��j� -E)DOOD -� f'S�' <br /> 0 <br /> (OBTIYNED FRON PROPERTYTAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> fNSTALL B REPAIR <br /> PROPOSED USE Q SFR � COMM � OTHER <br /> TYPE OF CON3TRUCTION Q BLOCK O FRAME � STEEL � <br /> DESCRIPTION OF WORK r�-°I-��� "-`?'�� ��f� �e /�-��/� <br /> BUILDING SIZE �--� SQ FOOTAGE� HEIGHT �� <br /> �BUILDING $ � (j f� �Q VALUATION OF TOTAL CONSTRUCTION <br /> � c7 <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ / `�� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> � `(/C( <br /> QGAS � ROOFING Q SPECIALTY � OTHER ��G <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � � <br /> BUILDER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> �d�$$ License# _� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER I COMPANY <br /> SIGNATURE REGtSTERED Y! N FEE CURREt� Y/N <br /> �d�� License# �— <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y J N <br /> Address License# �— —� <br /> OTHER :%��/ � � COMPANY �'�6�?2T5 <S<"32-��C�� <br /> SIGNATURE i����"' � REGISTERED Y/ N FEE CURRE� Y/N <br /> Aaa�$S .��i m��l/•�,��.��'� G'l� ���Gl u�se# CL��aS�,� � 7 <br /> � � � � � � � i � � � i � i � � � � � � � � � � i � � � � � � � � � � � � � � � � � � � � � i � � i � i � � � � � i � � � � i � � � <br /> RESIDENI'IAL Attach(2)Plot Pians;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum ten(10)woricing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/S�t Fence instaAed, <br /> Sanitary Facilides&1 dumpster,Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)c�mplete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Pertnit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon P�ans,Stormwater Plans w/Stlt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> StGN PERMIT Atfach(2)sets of Engineered Plans. <br /> •""'PROPERTY SURVEY required for atl NEW construction. <br /> •1 1 ■ <br /> Directions:• <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,�otarized <br /> If over 52500,a Notice of Commenceme�rt is required. (AIC upgrades over 57500) <br /> " Agent(for the contractor}or Power of Attomey(for the owner)would be someone with notarized letter from owner authoriiang same <br /> OVER THE COUNTER PEtipYtITTING (Frorrt of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />