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-------------_--,---_ <br /> , ��. ��-�-s �- < < � �,�1 ��°� <br /> 81�-�so-oo2o City of Zephyrhills Pe ' F�-s»-�ao-oo2� <br /> " Building Departrnent <br /> ��R�� i� �" �3 Phone Contact for Pennkd l�� a--°(� _ Cr q�ss� <br /> Owner's Name Rv SS c �1 Ua v�r�-�v1 Owner Phone Number C�`�"7�0-�',�(, <br /> Ownar's Address ` l � Lo�, j � Owner Phone Number <br /> Fee 8imple TiNeholder Ns�rw G.l:n�c.�s (�[,� a � �. �� Owner Phone Number �- � <br /> Fae 8tmple Tftlahoider Addross ��7'U 2-�. G.J;v�. ���� Z-e [, r�'� l� �L �j�'E a <br /> JOB ADDRESS �`�, �q, b � �r, LOT� � <br /> 9UBDMSION ���"`-��S (1'� (�-) P � PARCEL.ID� ��-�G-a'l-Qc�a�-UOaC,-Q6up <br /> {OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/AlT � SIGN O MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROP08ED U8E Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL Q OTHEF2 <br /> QESCRIPTION OF WORK '��-�-o'v�r t a lcS�O�\ �Q t � C���ct� �� �t � e W'qrz..-L <br /> BUILDING 312E SQ FOOTAGE ��a-O � HEIGHT <br /> Q BUILDING � � VALUATION OF TOTAL CONS CTI � 5� `� � �/��1 <br /> Q ELECTRICAL $ AMP SERVICE OG ERGY Q W.R.E.0 <br /> � PLUMBING � � �� <br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � ���' '"%� <br /> 2 Z � <br /> �/-�� <br /> Q GAS � ROOFING Q SPECIALTY Q OTHER "/ � ) � <br /> l.� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES �NO <br /> BUILDER �C�� �� COMPANY �--�s �� �-0;/�e r - �-{�•c., <br /> SIGNATURE "�\ RECsISTERED Y/ N FEE CURRENT Y/N <br /> Address License� <br /> ELECTRIqAN COMPANY <br /> SIGNATURE REG�STERED 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 /> 31GNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> A�^� License� <br /> OTHER COMPANY <br /> SIGNATURE RE(iISTERED Y/ N FEE CURRENT Y/N <br /> Addr�s 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. Ftequined onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Faalities&1 dumpster,Site Work Permit for subdivisions/iarge projects <br /> COMMERCIAL Attach{3)complete sets of 8uiidlr�Plans plus a Life Safey Page;(1)set of Energy Fortns.R-O-W Pertnit for new construction. <br /> Minimum ten(10)walci�days after submittal date. Required onsite,Construction Plans,Stom�water Plans w/Sift Fence instailed, <br /> Sanitary Faalities 8 1 dumpster.Site Work Permit for all new projecxs.All oommeraal requiremerrts must meet oomplianoe <br /> SIGN PERMIT Attach(2)sets of�ngineered Plans. <br /> *"`*PROPERTY SURVEY required for all NEW construdion. <br /> Dlrectiona: <br /> Fill out application completely. <br /> Owner 8 Contractor sign baqc of appiication,notarized <br /> If over;2b00,a Notice of Commencen+ent is required. (A!C upgrades over:5000) <br /> *" Agent(for the contrador)or Pow�er of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> pVER THE COUNTER PERNII'f'11NG � (Front of Appliption Only) <br /> Reroofs Sew�ers Set�utoe tfpg�` ' A/C Fenoas(PIoUSurvey/Footage) <br /> Driveways-Not over Counter'rf on public roadways..needs ROW � <br /> � <br />