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$i�-�8°'°°2° City of Zephyrhills Permit Application Fax-613-780-0021 <br /> Building DePartment �.5,�'►{�� (�-�ISl�R�M-s •G�M <br /> Date Received J' � Phone Contact for Permittin 7 � 3�-S g <br /> OwnersName �Qr:/L l�. �Pit/ �s�/ � OwnerPhoneNumber /3-' /�j� �S- �, <br /> Owner's Addresa � � L l� ,{�J hV Owner Phone Number �� � '��t�r' ` <br /> Fee Simple Titleholder Name Owner Phone Number � � <br /> Fee Simple TidehoMer Addresa <br /> JOB ADDRESS °j � ✓iv � LOT# �� <br /> �J <br /> SUBDIVISION PARCEL IDq <br /> (OBTA�NED FROM PROPERTY TAX NOTCE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME � STEEL Q <br /> DESCRIPTION OF WORK 7 / �` l �.�/r (� ;tr� <br /> BUILDING SIZE gQ FOpTAGE C� HEIGHT �� <br /> �BUILDING �I�v -�'�y� VALUATION OF TOTAL CONSTRUCTION <br /> L� <br /> �ELECTRICAL $ /��' d� AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> �PLUMBING $ � �_j �;��� <br /> � � N' � ( ; =c�-- <br /> QMECHANICAL $ � VALUATION Of MECHANICAL INSTA�LATION ����n C ` -S�� <br /> �� ��� <br /> QGAS ROOFiNG Q SPECIALTY � OTHER � i (., ( �r, ��� �,,��j��h����� <br /> FINISHED FLOOR ELEVATION FLOOD ZONE AREA QYES NO L� ``� G` ` <br /> BUILDER � ` o1COMPANY � (�/iQ C�'d�jP/�(./�l.� <br /> 31GNATURE �o�S�RED Y/ N FEE CURREn Y/N <br /> Address <br /> License# —� <br /> _. <br /> � ELECTRICIAN �� �y � <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y!N <br /> Address � <br /> License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y!N <br /> Address <br /> License# <br /> MECHANICAL COMPANY —� <br /> SIGNATURE REGISTEREp Y/ N FEE cuRREn Y/N <br /> Address <br /> License�k <br /> OTHER � � ��M?E�o Y/ N �E cuaREn Y!N � <br /> SIGNATURE <br /> Address License# � —~1 <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIiltllll <br /> RESIDENTIAL Ariach(2)Plot Plans;(2)sets of 8uilding Plans;(1)set of Enerpy Fortns;R-O-W Permit for new co�struction, <br /> Minimum ien(10)walcing days after submtttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary facilities&1 dumpster;Site Work Permit for subdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Lffe Safery Page;(1)set of Energy Forms.R-O-W Permit for new consUuction. <br /> Minimum ten(10)working days after submittal date. Required onslte,ConsWdion Plans,Stortnwater Plens w!Silt Fence installed, <br /> Sanitary Faciuties 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets d Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contracta sign badc of application,notarized <br /> If over S260Q a Notice o1 Commencement Is required. (A/C upyrades over E7500) <br /> " Apent(for the contractor)or Power of Atromey(for the owner)would be someone with notarfzed letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Ony) <br /> R�oofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counler'rf on public roadways..needs ROW <br />