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si3�aaoozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> BuOding Departrnent <br /> Date Received phone Contact for Permitti�g — <br /> T7lTTt �-1 /�' � r�iT"T� <br /> Owners Name � C�e /v1 V t�C�� Owner Phone Number <br /> Ow�ers Address � IC% �Q�. \.."N� - Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address � <br /> JOB ADDRESS 3 Ro3 e� �-4�-A� - 2e p4, cht`\S LOT# C� <br /> SUBDIVISION PARCEL IDM ��j ' 0��0�o��" (7 1 OO - O�d -�� <br /> �oerN�o Faor rrsorerm rnx rancet <br /> WORK PROPOSED � NEW CONSTR e ADD/ALT � SIGN � � DEMOI_ISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEI Q �� <br /> DESCRIPTION OF WORK f�E--V�Q� � <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> �BUILDING =� � VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL S AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING E ;/� ����� <br /> �/ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO / ��� <br /> BUILDER � COMPANY � <br /> SIGNATURE r�ctsre�o Y/ N F�cu�n Y/N <br /> Address Lice�se#� � <br /> ELECTRICIAN COMPANY � <br /> SIGNATURE �cis�aEO Y/ N F�c�n Y/N <br /> Address License# �_� <br /> PLUMBER COMPANY � <br /> SIGNATURE REGtSTERED Y/ N FEE CURRE� Y/N <br /> Addre� License 3� � <br /> MECHANICAI. COMPANY � <br /> SIGNATURE r�ciS�a�o Y! N F�cuw�n Y/N <br /> Address � license i � <br /> OTHER � �� ����_ COMPANY _/� I�C� � �✓�� <br /> SIGNATURE REGISTEF�D Y/ N �E c�xtrt�n Y/N <br /> Address ��� 1���� �,e • License# �J�C'+�c C^C��'{'3�7 <br /> 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 A 1 I 1 1 1 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of 8uilding Plans;(1)set of Energy Fortns;R-O-W Pertnit for new consWction, <br /> Minimum ten(10)worKing days after submittal date. Required onsite,Constiuction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Pertnk for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Bu'Winp Plans plus a L'rfe Sately Page;(1)set of Energy Forms.R-aW Permit for new construction. <br /> Minimum ten(10)owrking deys efter submittal date. Required onsife,Constnx;fion Plans,Stormrrater Plans w/Silt Fence instaNed, <br /> Sanifary Faalities&1 dumpster Sile Work Pertnil for all new projeds.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: i 1 1 1 � 1 1 1 1 1 1 1 1 <br /> Fill out application completey <br /> Owner&Contrador sign back of applica6on,notarized <br /> If over SZS00,a Notice of Commencement ts requlretl. (AIC upgrades over 57500) <br /> " Agent(for the contrador)w Power of Atlomey(for the owneh would be someone with notarized letler from owner authorizing same <br /> OVER THE COUNTER PERMITTtNG (front W Application Onty) <br /> Reroofs'rf shingles Sewers Service Upgrades A/C Fences(PbUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />