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� �_ <br /> � Print Form <br /> ` -� - Y a�saso-oozo City of Zephyrhills Permit Appiication FaX-8�3-� - <br /> Building Department �;-,< <br /> vU <br /> Date Received �C Phone Contact for Permitting l� � — ( � � � <br /> Owner's Name �(/�,'�"V {C�(Ol. S��-� � Owner Phone Number (b 13 J "T� 1 ` l ( °?7 <br /> Owner's Address 3 p�� I rOc�I W O�d S �O�G� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �S�D� I V�DI�W O0� �I GLGQ LOT# � <br /> SUBDIVISION �Y I�TW�O� "°t" 2C' ��S PARCEL ID# oa-a�-a i- o��� -oo OD— L7�.30 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT � SIGN Q MOVE O DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR 0 COMM Q OTHER CON O lUltAf� <br /> TYPE OF CONSTRUCTION � BLOCK 0 FRAME 0 STEEL Q OTHER <br /> DESCRIPTION OF WORK �e ��`� � W11��t.,S S(Ze S!2� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> � BUILDING $ � ( I � �.W � TION OF TOTAL CONSTRUCTION \�J�� <br /> .�� <br /> � ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � Q W.R. . <br /> f � <br /> � PLUMBING $ �al�� <br /> (l� Z�' � ��rr���— <br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �j M/l <br /> l //) `j�,(��,Lt <br /> 0 GAS 0 ROOFING 0 SPECIALTY � OTHER `� ^ �lti`' <br /> � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES QNO <br /> —1 � <br /> BUILDER James Rowland � .D COMPANY PWD-Orlando, Inc. ' �S <br /> SIGNATURE REGISTERED Y N FEE CURRENT N <br /> Address 350 W. State Rd. 434, Longwood, FL 32750 License# CBC046712 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED 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 /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address I I License# I <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 after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&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&1 dumpster Site Work Permit 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 construction. <br /> Directions: <br /> Fill out application completely ' <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$5000) <br /> '* Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />