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� 8t3-��?� City of Zephyrhills Permit Applica6on Fax-813-780-0021 <br /> Building Depar6nent <br /> Dats Rscsivsd phone CoMad for ParmHtln <br /> - T77-TT-iTr - <br /> owners Nsms �P� b-9wner Phone Number !3— --1 ( �� <br /> Owner's Address !'�� G� / . -T l�• Owner Phone Number � <br /> Fee Simple Titleholder Name �� Owner Phona Number �- � <br /> Fee Simple Titleholdar Addross <br /> JOB ADDRESS V S � �C�� � . E'l�°� LOT i C.��J <br /> SUBDIVISION h;/TVl.� PARCEL IDk l `� °�'(""U�"O d UL`� �2 <br /> (08TAINED FROY PROPERTY TA7C NO710E) <br /> WORK PROPOSED e NEW CoNSTR 8 ADDIALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q ���� <br /> DESCRIPTION OF WORK �ICE/ - `'� '� <br /> BUILDING SIZE S FOOTAGE � U HEIGHT � � ( <br /> QBUILDING S � ��� VALUATION OF TOTAL CONSTRUCTION <br /> C/ <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ; / <br /> � v � \/ � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � n ,,��Q/ � <br /> I fAV\. <br /> � � l.i'' � V " <br /> QGAS � ROOFING Q SPECIALTY Q OTHER ,� � <br /> FINISHED FLOOR ELEVATIONS FLOOD 20NE AREA �YES NO � <br /> BUILDER COMPANY 6W �lE'�t_� 6+vv�CNb- '�` w ���� �-�"l� <br /> SIGNATURE "� �cisrEr�o Y/N F�cur�n Y/N <br /> Addross �/�Ss� � '�{"-�L�S.. �L. �SS '�� License# C�Z�L �� <br /> ELECTRICIAN COMPANY <br /> SIONATURE REGISTERED Y! N FEE CURRE� Y!N <br /> Add►ess License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address License# � <br /> MECHANICAL � � COMPANV � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address License# � <br /> OTHER � COMPANY <br /> SIGNATURE r�cis�rs�o Y! N F�cuRaEn Y/N <br /> Addresa License# <br /> IIIIIIIIIIIIIt1i111111111111111111111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new consWction, <br /> Minimum ten(10)working days aRer submittal date. Required ons8e,Construction P�ans,Stortnwater Ptans w/Silt Fence installed, <br /> Sanitary Facilfties&1 dumpster;Site Work Pertnit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a L'rfe Safety Page;(1)set of Energy Forms.R-aW Permit for new construc[ion. <br /> Minimum ten(10)waking days after submittal date. Required onsite,ConsVuction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projec[s.Ali commercial requiremeMs must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineared Plans. <br /> ""PROPERTY SURVEY required for all NEW consWdion. <br /> Dlrodlons: <br /> Fill out application completely. <br /> Owner 8 Contractw sign back oi application,notarized <br /> If over 52500,a Nodce of Commsnesment is required. (NC upg�ades over 57500) <br /> " Agent(for the conVactor)w Power of Attomey(iw the owner)would be someone with notarized letter irom owner authoriang same <br /> OVER THE COUNTER PERMITTING (Frart of Application Ony) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fenc�(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW <br />