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s��-�ao-oozo City of Zephyrhills�ermit Application Fax-813-780-0021 <br /> Building D partment <br /> � Date Received ��3 ��� �(�l}I K,[ �-(��y <br /> � Phone Contact for P rmitting - <br /> Owner's Name I �lr h V U�w�V� Owner Phone Number �J�7�p �oW�7 <br /> Owners Address � /,)1 � �/V� ��"���`� Jt Owner Phone Number <br /> Fee Simple Titleholder Name ��-�- Ovmer Phone Number <br /> Fee Simple Titleholder Address SG`VY�� <br /> JOB ADDRESS �� 33 N e��n-, (�-(/�Q� LOT# �� <br /> SUBDIVISION V�V�C�. �IVvIL(h�lS pARCELI �'I�aS��f' QO' C���' U��6 <br /> (OBTAINED FROM PROPERTY TAX NOTIC� <br /> WORK PROPOSED e NEW CoNSfR� ADDlALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER / � <br /> TYPE OF CONS7RUC710N Q BLOCK � FRAME Q STEEL Q <br /> DESCRIPTION OF WORK dKJ X-17 T��W�(��OJ� V�C7 <br /> BUILDINCi SIZE �`t U 11 �C �� `� SQ FOOTAGE �3�� HEIGHT �31 <br /> �BUILDING S�y� n c� VALUATION OF OTAL CONSTRUCTION <br /> i-o -� b � <br /> �ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ I�,�%� � <br /> ' <br /> �MECHANICAL $ VALUATION OF ECHANICAL INSTALLATION � <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZON AREA QYES NO <br /> � <br /> BUILDER COMPA u�r ���� <br /> SIGNATURE REGISTE ED Y/ N FEE CURREN Y/N <br /> Address �xY V 3 J-� JIY�I�-Gt V�C, �� 3�� License# f17 /DO���T u <br /> ELECTRICIAN �. REOGIMSTE o ���/�vl FEECURRENS�fY� G� I�� <br /> SIGNATURE <br /> Address �r��'������ T �l 33�07 License# C. O� Sa� <br /> PLUMBER // COMP Y �U�-�� ►"t 1,�G` <br /> SIONATURE / REGISiE ED Y/ N FEE CURREN Y/N <br /> Address ��3 Z� �u)� tY °� J 3� License# �IT/�o�S��f!J <br /> MECHANICAL � COMP 1! 7�N ���1�- � �r � <br /> SIGNATURE rtecisre eo Y/ N FEE CURREN Y/N U <br /> Address ��UX� (�y�� / Gt 3��Q�7 License# L����/�J J�� <br /> OTHER COMP <br /> SIGNATURE REGISTE ED Y/ N FEE CURREN Y/N <br /> Address L'icensa� <br /> Illilllllllllll � lllllllltllllllllll Illlllllllllllllllllllllltlllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of E ergy Forms;R-0-W Pertnit for new construdion, <br /> Minimum ten(10)working days after submittal date. Requir d onsite,Construction Pians,Stormwater Plans w/Silt Fance installed, <br /> Sanitary Fadlitias&1 dumpster;Site Work Permft for subd'isions/large projects <br /> COMMERCIAL Attach(3)complete sets of Buiiding Plans plus a L'rfe Safety Paga;(1)set of Energy Fortns.R-0-W Permit for newconstrudion. <br /> Minimum ten(10)working days after subm'rttal date. Requir d onsite,ConsWdion Plans,Stortnwater Plans w!Silt Fence installed, <br /> SaniWry Fadlities&1 dumpster Sita Work Permit for all ne projects.All commercial requirements must meet compliance <br /> SI�N PERMIT Attach(2)sets of Engineered Plans. <br /> •'••PROPERN SURVEY requ(red for all NEW construction <br /> Directions: <br /> Fill out apptication completely. <br /> Owner&Contredor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over 57500) <br /> " Agent(for the contrador)or Power of Attomey(for the owner)would be so eone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI7TING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plo Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />