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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> _ ;, Building epartment <br /> 4 <br /> Date Received Phone Contact for ermittin o � 3 ��Z -- � U`� <br /> Owner's Name �G�i !Y)�J' ��i�/e Owner Phone Number 7 �! Sos 3�3 <br /> Owmer's Address ���U �'/.(��� Ouvner Phone Number / � c3 2����L <br /> Fee Simpte Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �� �� �UJl> � P� L°L�D /`(fg LOT# � <br /> SUBDIVISION PARCEL I # d� � � D��� �dbO� L�7�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADDlALT 0 SIGN Q Q DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK 1�t��"��'� A G C— � O N t{ ,� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ VALUATION O TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ��{ <br /> b �' <br /> QMECHANICAL $ ����e �� VALUATION O MECHANICAL INSTALLATION � �� <br /> QGAS Q ROOFING Q SPECIAL 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO <br /> BUILDER COM ANY <br /> SIGMATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN - COM ANY <br /> SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER CORA ANY <br /> SIGNATURE REGI ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COM ANY �1"��25�(�/�FI��' �`FS �'����Ci <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# �'��2✓��� <br /> OTHER CO PANY � <br /> SIGNATURE REGI TERED Y/ N FEE CURREI� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set o Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Re uired.onsite,Construction Plans,Stormwater Plans w/Silt Fence instafled, <br /> Sanitary Faci�itfes 81 dumpster;Site Work Permit for su divisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Sa�ety Page;(1)set of Energy Forms.R-O-W Pertnit for new construction. <br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGM PERMIT Attach(2)sets of Engineered Plans. <br /> '••'PROPERTY SURVEY required for all NEW construc on. --- _ <br /> Directlons: � <br /> Fill otit application completely. <br /> Owner&Contractor sign back of application,notarized„ � <br /> If over 52500,a Notice;of-Commencement'ts`�equired.�••(NC�;upgra es over 57500) <br /> "• Agent(for the contractor)or Power of Attomeyr(for..the owner�iivould b someone with notarized letter�from�owner authonijng same��-�`;"`�i, <br /> -, z _ _ �_ , � • ; • ,. <br /> OVER THE COUNTER PERMITTING''� �; (Front of Appllca.tion.,Q�nly,) ' - � � • �'�' <br /> Reroofs if shingles Sewe�s ;; 'ServiFe_Upg ( Y 9 ) y` , ,' � �' ';', � �•-f <br /> rades.AlG�T--�°Fences Iot/Surve /Foota e l 4 <br /> .., - - JT... ..,.... ......,.._,n.,.:�.�, . ,. ,_.�-..-.>.,�.�.t, <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> L <br />