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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> A Building Department <br /> , <br /> Date Received �"� `,� r'S`! phane Contact for Parmitting <br /> Owner's Name � �°�-� Z--e��n �.,�� Ctwner Phone Number <br />', Owner's Address J�� t7 hn .5� - Owner Phone Number � � <br />' <br /> iI Fee Simpie Titiehatder Name � � Owner Phone Number � � <br /> I <br /> i <br /> Fee Simple Titlehalder Address <br />', JOB AbDFiESS �/ .S 1 � �`t ,:���i .._ W4 L07# �� <br />� <br /> suea�visio� ��^°��� �Q�g`'� � �artc��Ea# <br /> (OSTAINED FRCM PROPER'TY 7AX NOSICE) <br /> WdRK PROPOSED , e NEw CoNSTR 8 ADQlA�T �] SIGN [,� Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED U$E Q SFR Q COMM �] QTHER <br /> TYPE QF GONSTRUC710N Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTfON OF WQRK �i���w�� n�i•.1 �t•��.f -tt[pr�y. � L"" �'o,.�'tds w <br /> SUlLDlNG SlZE � � SQ FOQTAGE�� HEtGHT �.�,� <br /> ', 08UII.DING $ VAt,UATiON OF TOTA�CQNSTRUCTION <br /> [��ECTRICA� $ AMP SERVICE �'PROGRESS ENERGY C] W.R.E.G. <br /> ' QPLUMBING $ <br /> ��_� <br /> �MECHANICAL �i � VALUATION OF MECHANICAL INSTALLATIQN <br /> [�GAS Q ROOFIRIG Q SPECIALTY [_,� OTHER <br /> FINiSHED FLOOR ELEVATIONS � � FLOOD ZQNE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGFtATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> � Address t,lcense# � � <br /> �.�.,�, <br /> ELECTRICIAN ,�'j r����,���'/�.^_�#�--" COMPANY <br /> SCGNATURE ��""� 3'"` REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres$ i.fcanse# � � <br /> PLUMBER � � COMPANY <br /> SIGNATilRE ( REGISTERED Y J N FEE CURREA Y J N <br /> Address ucense# � � <br /> MECHANICAL COMPANY <br /> SiGNATURE REGI57fRED Y I N FEE CURRE� Y/N <br /> Address License# �- � i <br /> OTHER COMPANY <br /> StGNATURE REGISTERED Y J i1) FEH CURREh Y!N <br /> ,�,.�„_,.� <br /> Address License# �- � <br /> RE3IDEN'f{A1. Attach{2}Ftot Pians;(2}sets of Buitding Plans;{1}set of Energy Forms;R-Q-W Permit for new construction, <br /> 4ltlinlmum ten(10)workfng days after submtttai date. Required onslte,Conshuatlon Plans,Stormwater Plans wJ Sitt Fence instaited, <br /> Sanitary FacillUes&1 dumpster,Site Wor1c Permit for subdivisionsAarge projects <br /> CQRfiMERC1AL Attach(3)complete sets of Buildirig Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construation. <br /> fUltnirr�um ten(10)warking days after submlttal date. Reqaired ortsite,Constructian Pians,Stormwater Plans wi Silt Fence instat{ed, <br /> Sanitary Facilides&1 dumpster.Stte Work Permit for all new proJects.All commercial requlrements must meet compliance <br /> 31GN PERMIT Attach(2)sets of Engineered Plans. <br /> "*"PROPERi'Y StJRVEY requfred for aii NEW construction. <br /> Directions: <br /> Ftii out appticatlon campletely. <br /> Uwner 8 Conkractor sign back of appl(ca@on,notarized <br /> If over 52500,a Notice af Commencement is requtred. (A/C upgrades over 57'500) <br /> " Agent(for the contractor)or Power af Attomey(for the owner}would be someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingtes Sewers Service Upgrades A/C Fences(PIot/SurveyiFoatage} <br /> Driveways-Not aver Counter if an public roadways..needs ROW <br />