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$�3aso-aa2fl � City of Zephyrhills Permit Applicatian , FaX-$�3-7ati-aa2z <br /> ' Building Department <br /> Date Received Phone Contact far Permitting -- <br /> Owner's Name �� . �� Owner Phone Number <br /> i1�Erst Z� '�'¢ O <br /> Owner's Address lo �$'Z Owner Fhone Number� � <br /> Fee Simple Titlehoider Name Owner Phone Murriber�- � <br /> Fea Simpis Tiftehalder Address <br /> aos A�oa�ss 556 B Q.n�: ��- �.of� � �1..� <br /> su���vls�or� C��__�!'�.�o:�a. 0.t' PAEtCE�tD# �Z•2lP• 2L- bo2�g- bo�do- oaoo <br /> _,_—__ __.__ _� �__ (08TAtNEB FROM PROPERTY TAX NOTiCE) <br /> WORK PROPOSED NEW CONSTR ADD/AL.T � SIGN 0 MOVE � ��DEMOCISH� —�`- <br /> e 1NSTA�.[. e REPAIR <br /> PROPOSED USE � SFR 0 - COMM Q OTHER <br /> TYPE OF CONSTRUCTIQN � BLOCK � FRAME � STEEi� Q OTHER <br /> DESCE2[PTION QF WOE2K �csz. a� � .Q,. ' Y1, <br /> .> <br /> BUl�D1N�SIZE �� � SQ FOOTAGE � HEtGHT �J � <br /> 0 BUILDING I$ � � VALUATION OF TOTAL CQNSTRUCTiON <br /> � <br /> � ELECTRICAL $ �0�4„ � AMP SERVICE �,] PROGRESS ENERGY Q W.R.E.C, <br /> 0 PLUMBING � � �.,.-��� <br /> 0 MECHANICAL � � VALUATION OF MECHANICAL INSTALLATION <br /> � {l <br /> I 0 GAS 0 ROOFING � SPECIALTY � OTHER <br /> FIN1SFlED fiLQOR ELEVATIONS � � FLOOD ZONE AREA [�YES ONO <br /> BUILDER COMPANY <br /> S[GNATUi2E �?EGlSTEREp Y J N FEE CUi2RENT Y 1 N <br /> Address � License# �— ��� <br /> ELECTRICIAN � COMPANY U-�.�11 C„.��-�t'tC. �1..f'\�-- <br /> SIGNATURE , REGISTERELt Y I N FEE CUf2RENT Y I N <br /> Address �.��b''�C.4'3"] ���,,.� "3'3�,2 License# �<<��JOI�$� � <br /> PLUMBER COMPANY <br /> SIGNATt)RE REG]STERER Y/ IV FEE CUt2RENT Y/hl <br /> Address Lioense# �� � <br /> iNECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/R! <br /> Address License# �— � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CUI2RENT Y/N <br /> Address License# �— � <br /> RESIp�NTIAL Attach(2)Plat Pians;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new consfruction, <br /> Minimum ten(10)working days after submit#al date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciEities&1 dumpster;Site Wark Permit for subdivisianslEarge projecfs <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set af Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten{10)warking days after submittal date. Required onsite,Construction P(ans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit far a1(new projecfs.AI(commercial requirements must meet comptiance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> """PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fiii out application compiekely. <br /> Owner&Confractor sign back of applicafion,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$5000) <br /> `* Agent{for the contractor}ar Power of A#tomey(for the owner}would be someone with no#arized letter from owner authorizing sarrie <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Rerao#s 5ewers Service Upgrades AlC Fences{PioUSurvey/Footage) <br /> priveways-Not over Counter if on public roadways..needs ROW <br />