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. ' <br /> • 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0027 <br /> Building DepaAment <br /> Date Received Z� 53 B � 1.�� <br /> Phon ContactforPermittin <br /> Owner's Name �rxxn-`r-} �� M�L�-1/�h-�r Owner Phone Number B�3-35-5�-3SLo <br /> Owner's Address tp�o� �U R-'�-) �-,A�C .ly�- Owner Phone Number ' <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Tideholder Address <br /> JOB ADDRESS lL l�O� ��L�-] L/�t � U` LOT# �� <br /> SUBDIVISION c N�I-,S CzL-EYV PARCELIDN o3-7-(0-�-1-oi5o'O�ODD" DZSO <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q�OTHER 1 N S <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK Rm��cc 3 I 1��WS SI ZG- S�ZL I--�N�►n�Pv.C i- <br /> BUILDING SIZE S�FOOTA E� HEIGHT � <br /> i <br /> BUILDING S �� n ALUATION OF TOTAL CONSTRUCTION <br /> G <br /> QELECTRICAL $ MP SERVICE Q PROGRESS ENERGY Q W.R.E.C. � <br /> QPLUMBING $ . . . ' . . I . ����� <br /> QMECHANICAL $ ALUATION OF MECHANICAL INSTALLATION <br /> . � <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER t� t�OMPANY � I����' ��`���ti"WNCG AI�I.(�/uL'C <br /> SIGNATURE REGISTERED Y/ N FEECURREI. Y!N <br /> Addr s L V� �I-� � ��� Y'L J��1�e License# C czC ���U V �-10 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> I SIGNATURE REGISTERED Y/ N FEECURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y( N FEE CURRE� Y/N <br /> Address License# <br /> IIIIIIIIIItllllllltllllllll Illllllllllllllllllllllttlllltllllllllt <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building lans;(1)set of Energy Forms;R-0-W Permit for new construction, <br /> Minimum ten(10)working days after sub ittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Wor Permit for subdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after sub ittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster Site Wo Permit for all new projects.All commerciai requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> II ""PROPER7Y SURVEY required for all EW construdion. <br /> Directions: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized <br /> If over�2500,a Notice of Commencement is require (AIC upgrades over$7500) <br /> " Agent(for the contraclor)or Power of Attomey(for the o er)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicat on Only) <br /> Reroofs if shingles Sewers Senrice Upgrades A/ Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..nee s ROW <br />