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, <br /> 613-780-0020 Ciry of Zephyrhills ermit Application Faz-613-780-0021 <br /> � • ' Building D partment <br /> i <br /> pate Received ��� L�? __ ��0� <br /> Phone Contactfor P rtnitting <br /> T6"T6-'6-66'3-'� " T�'6-1 e <br /> Owner's Wame � Owner Phone Number <br /> Owner's Address � � 7 K(„i1�� � Owner Phone Number <br /> F¢e Simple Titleholder Name Owner Phone Number <br /> Fee Simple TiUeholder Addrese - <br /> JOB ADDRES5 �"'r" LOT# � <br /> SUBDMSION PARCEL 1 �U' � �C� - <br /> (08TAINE�FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR 8 ADD/ALT 0 SIGN � Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> ¢it5fi�l w�,r�t,' � w�/ s ti w. o� �ec��ir� v=[o„Kect <br /> UESCRIPTION OF WORK K!S�t� E�rcfv'!C• <br /> BUILDING SIZE /O g ! �`� , SQ FOOTAGE �6� HEIGHT a� , <br /> BUILDING $a rSO.d� VALUATION OF OTAL CONSTRUCTION <br /> �ELECTRICAL $ 5,Q O O AMP SERVICE � °ROGRESS ENERGY Q W.R.E.C, kQ� <br /> c� v ` <br /> QPLUM8ING $ ��_\ ��k�a��` � <br /> QMECHANICAL $ VALUATION OF ECHANICAL INSTALLATION ��� � ,���y, ` <br /> , `�/ d '�Q� S�/ <br /> � y� �`, <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER L <br /> fINISHED FLOOR ELEVATIONS FLOOD ZO E AREA QYES NO ����U�J'+-� i <br /> � � <br /> BUILDER � ✓COMP Y ��� S� S P��iV`��►1 <br /> SIGNATURE REGISTE EO Y/ N FEE C RREI� Y/N <br /> Address ry License# I <br /> ELECTRICIAN R 6�COMP Y � <br /> SIGNATURE 1�M'�"� '�� REGISTE ED Y! N FEE CURREA Y 1 N <br /> Address �� I License# � .7�J� <br /> PLUMBER COMP Y <br /> SIGNATURE rtE�IS7E � Y 1 N FEE CURRFI. Y/N <br /> Address License# <br /> MECHANICAL COMP NY <br /> SIGNATURE REGISTE ED � Y 1 N FEE CURRE� Y/N_ � <br /> Address License# <br /> CITFIER COAAP <br /> SIGNATURE t�ais� o Y I N FEE CURRE� Y/N <br /> Address License# <br /> � � � i � � � i � i � � � ii � i � i � i � i � � i � � � � � � � o � ii � � � iti � � � � � i � ie � ei � i � � � � � i � e � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)set of E ergy Forms;R-O-W Permit for new construcdon, <br /> Minimum ten(10)wocking days after submiltal date. Requir�d onsite,ConsWCGon Plans,Stormvrater Plans wl Silt Fence Installed, <br /> Sanitary Facllities&1 dumpster,Site Work Pertnit(or subdi Isions/large praJects <br /> COfiAMERCIAL Attacn(3)complete sets of Building Pians plus a Life Safei Fage;(1)set oi Energy Fortns,R-O-W Permif ior new construction. <br /> Minfmum te�(10)working days after submittal date. Requly d onsite,Construction Plans,Stormwater Plans w!Silt Fence(nstalled, <br /> Sanitary Facllities&1 dumpster.Site Work Pertnit tor all ne projecls.All commercial requirements musl meet compliance <br /> SIGId PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction <br /> Directlons: <br /> Fill out applicafion completely. <br /> � Owner&Con[ractor sign back of application,no:arized <br /> If over 52500,a Notice of Commencement is required. (A/C upgrade over 57500) <br /> " Agent(for the conirac[or)or Po�ver of Attomey(fer the owner)�veuld be so eone w.ith notarized lerier frem o�ner authorizing same <br /> OVER THE COUMTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plo Survey/Pootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />