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a�3-�so-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date ReceivecJ I YL._20� i� <br /> Phone Contact for Permittin �g _ Q 0 <br /> Owner's Name L( �._-[7t�'n j� Owner Phone Number <br /> Owner's Address 3��-�'3�o M Ct,�'}'��"�� Ow�er Phone Number <br /> Fee Stmple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address 2,2 S O O_ q�( <br /> JOB ADDRESS �� ' � �� � <br /> LOT# <br /> SUBDIVISION V C�l.1��.4 �(�,� PARCEL iD# O aJ-2.fp-2�- a{"'� —tjpp �p^ �t„�,�„�� <br /> (OBTAINED FR�OM pROPERTY T�nce)DEMOLISH <br /> WORK PROPOSED B NEW CONSTR 8 ALT [� SIGN <br /> INSTALL p <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CON3TRUCTION Q BLOCK Q FRAME C� STEEL � <br /> DESCRIPTION OF WORK c�,t{� �"'�,Q�-�-�� l U �� � <br /> BUILDING SIZE SQ FOOTAGE C] HEIGHT <br /> QBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> mELECTRICAL $ AMP SERVICE � �R��,��,`') <br /> � S� • u;� C] W.R.E.C. <br /> QPLUMBING � <br /> C]MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION -�Y /L��''�`f� � <br /> '/ ( ( <br /> �]GAS Q ROOFING Q SPECIALTY <br /> C� OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANX <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> ELECTRICIAN Cr�./Y� ��- COMPANY �Q.Q�.Q- �)2L-�C.t�.-I ��-t., <br /> SIGNATURE REGISTERED / N FEE CURRE� Y/N <br /> Address �DX ��p 2. {1"1��I� Tt„�j� License# �-��J�O��"� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# � <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y J N <br /> Address 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)woricing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facflities 8 1 dumpster;Site Work Permit for subdivisions/large 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(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Perm(t 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 constructlon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notartzed <br /> If over 52500,a Notice of Commencement(s required. (A/C upgrades over s7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone wlth notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of AppUcaHon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW <br />