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• s��-�eaoozo City of Zephyrhills ermit Application Fax-813-780-0021 <br /> Building D partment <br /> Date Received 9 ( �S� �6 3� _'�O <br /> Phone Contactfor P ittin <br /> -t-fTI-1-1-t 1- /� -� / - '1-'1"'1"1-� - - <br /> Owner's Name L,D L � L.L-�-% Owner Phone Number <br /> OwneYs Address �/�Y �( ./L', a✓� ��l S-1 e,l�� ��e'�umber <br /> Fee Simple Tltleholder Name /v � Owner Phone Number <br /> Fee Simple Titleholder Address I�t <br /> JOB ADDRESS 3 a h• S-� Z �� �( �— 3���� LOT# 1�^(� <br /> SUBDIVISION PARCEL.ID# ��^�^'� Z[`��O�"I�1C7 C7�'O��O <br /> (OBTAINEO FROId PROPERTY TAX NOTILE) <br /> WORK PROPOSED B NEW CaN57R e ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK D' �'!�'�l�{ � G, � S � l� ��� (p. �1r�t-✓ ��°„• ��� ! ' �/'j4�/'S <br /> 7'/!O � <br /> BUILDING SIZE � �J SP,�j� SQ FDOTAGE I !� HEIGHT �� � <br /> Q$�UILDING S ���� VALUATION OF TAL CONSTRUCTION <br /> �ELECTRICAL��{' $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> dPLUM8ING $ ��� � �i/�' / /= , <br /> l `` ' (�� <br /> �MECHANICAL S y/�LUATION OF ECHANICAL INSTALLATION � � �` r J\�J� <br /> ��2"�<.J ci'•� �. ,� v <br /> QGAS'�U�R 0 ROOFING Q � SPECIALTY � OTHER �� � <br /> FINISHED FLOOR ELEVA710NS FLOOD ZON AREA �YES NO � � <br /> � � <br /> � <br /> BUILDER MP Y �G,�..�S � o <br /> ,Or r�� �n ��!� <br /> SIGNATURE REGISTE o Y! N3� �ECURREA Y!N <br /> '7 �// u <br /> Address S7 o{t •'� �7<K 5 r,j�1%� %'� �.�� License� <br /> ELECTRICIAN COMP Y '`�'I!� <br /> SIGNATUR£ REGISTE o Y! N FEE CVRREP Y/N <br /> Address License# <br /> ,� <br /> PLUMHER � COMP Y J� S ��Yrl Si•'7- <br /> SIGNATURE EGIST o Y/ N FEE CURREA Y!N <br /> Address .� ) i,tij�(? f �i�;�)�1 3�,��y �Z l7 <br /> J cense# <br /> MECHANICAL ` ll / / COMP Y P,)Ci�✓ :1J�1�$r%}1 I'�'1�1 J9Yl:�i! <br /> SIGNATURE G REGI57e D Y! N FEECUrut�n Y/N <br /> Address /���Ca. /�1 Oi'1 �� � r1� ��� �� �� �� License# <br /> OTHER COMPA Y <br /> SIGNATURE REGISTE o Y I N FEE CURREA Y 1 N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIf1111111111111111i111111111111tllllt111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buflding Plans;(1)set of En rgy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days aRer submittal da1e. Require onsiie,ConsWction Plans,Slormwater Plans w/Slt�Fenr,e Installed, <br /> Sanitary FeciliUes 8 1 duinpster;Site Work Pertnit for subdivi ionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life'Sa(ety age;{1)se[of Energy Forms.R-O-W Pertnit for new construdion. <br /> Minimum teri(10)working days after submittal dale. Require onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facililies&1 dumpster.Sile Work Permit for all ne proJects.All commercial requiremenLS must meel compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERIY SURVEY required for all NEW consWction. <br /> Directions: <br /> Fill out application completely <br /> Owner 8 ConVactor sign back of applicatlon,notarized <br /> If over S2500,a Notfce of Commencement ls required. (A!C upgrades ver 57500j <br /> " Agent(for the contractor)or Power ot Attomey(for the owner)arould be so eone�vith notarized letter Gom owner authorizing same <br /> OVER THE COUNTER PERMfTTING (Front ot Applicalion Onty) ' <br /> Reroofs'rfshingles Sewers ServiceUpgrades A!C Fences(Plolf urvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />