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s�s-�so-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> �/•�/��G'%/� 4(/, (...°%�L(/2 C/�'!{/G G L Building Department <br /> �1 i 3 � o�t �-[�� 2 <br /> Date Received d l3 33 -- 77� <br /> Phone Contact for Permittin <br /> Owner's Name / � Owner Phone Number - 7�0 �� �`�1d7 <br /> Owner's Address , lJ r ,J(' 3J p r / � �j Owner Phone Number �- <br /> Fee Simple Titleholder Name � /� Owner Phone Number � <br /> / <br /> Fee Simple Titieholder Address � <br /> JOB ADDRESS ��� ��� � 1.�� LOT# � <br /> SUBDIVISION �/S�� PARCEL ID# Dp� � ' Q U-'�/� ''�Q(�j/ <br /> (OBTAINED FROM PROPERTY 7AX NOT�CE) <br /> WORK PROP03ED NEw CONSTR ADD/ALT 0 SIGN [� Q DEMOLISH <br /> INSTALL � REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK /\'CCD l t'l •�'�`J e ��' (t���� /yl�/!5 C[1/��E��j �Ir�u/�p��• <br /> BUILDING SIZE � 3Q FOOTAGE Cy� HEIGHT �� <br /> OBUILDING $ ��0� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE - 0 PROG �ENERGY Q W.R.E.C. <br /> , �,,.-- <br /> QPLUMBING $ � '� � <br /> ziz�''-t��ra��S ' � . <br /> QMECHANICAL $ ALUATION OF MECHANI AL� AL TIO ` `� ��� ' <br /> QGAS ,� ROOFING Q SPECIALTY �] OTHER -____._,_. <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# -� <br /> MECHANICAL COMPANY <br /> SIGNATURE STER Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> � ° .�-� /� <br /> OTHER � e O PANY ��) lr /."�.�.� KCc � I.�, C <br /> 31GNATURE " EGISTERED Y/ N FEE CURRE� Y/N <br /> Add�ess �y7 �3�r cf� � � r/�j.�/� 3�S G LiCense# ���G'�%3Jo <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)wo►king days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Woric Permit for subdivisfonsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(70)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Pennit for all new projects.All commercfal requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '"'"PROPERTY SURVEY required for all NEW consVuction. <br /> Directlons: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgradea over s7500) <br /> `" Agent(for the conUactor)or Power of Attomey(for the•owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITT1NG (Front of Application bnly) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />