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813-780-002Q ' City of Zephyrhills Permit Application Fax 813aso-oo7� <br /> Buildng Qepartmeat <br /> Da#e Recelved Phone Can#act for Permitting - <br /> Owner's Name o!t/ � e Owner Fhone Nurnber �.3 -�' 3 ��� <br /> Qwner's Address c� '0 �i!�� ,B (/E Owner Phone Number �_ -� <br /> Fee Simple Titleholder Name /���x��,� ���[/fl/✓/E��-- Owner Phone Number � � <br /> Fee Simple Titleholder Address ��� � � � Z� /` �S ��� <br /> JOB ALIDRESS �/�c�a ,4, �.G �, h � � ��J LOT# �Ca I <br /> StlBDIViSION G�RAI� ��f�.o,�� PARCEL ID# ��'02�Z/"C�J� ' Od D�d .- �?/'D <br /> (QBTAINED FROM PROPERTY TAX NQTiCE) <br /> WORK PROPOSEQ e PiEW CONSTR 8 ADD/ALT [ t� S1GN � Q DEMOLiSH <br /> INSTALL REPAIR <br /> PRQPOSED USE Q SFR Q C{?N1M [� OTHEF2 <br /> TYPE 4F CONSTRUCTION � BLOCK Q FRAME � STEEL � Q, a�r.,.t„u�•... <br /> DESCRIPTION OF WQRK �C R��� ��'1 �� <br /> BUILDING SIZE ��j k /S j � SQ FOOTAGE �"� HEiGHT I�� <br /> Q�3Ui1.DlNG $a���,.-�6 � VALUATION OF TOTAL CONSTRUCTION <br /> [�ELECTF2ICA�. r> � AMF SERt/iCE Q PROGRESB ENERGY Q W.R.E.C. I <br /> L 2 .� <br /> OP�ur����v� � '� 1� � <br /> c� d'`l{3�',,,�r� <br /> OMECHANICAi. $ V,4�UATION OF MECHAP11CA1.INSTA�tATICJN �,,.. �St..�1 � <br /> QGAS Q ROOFING Q SPECIA�TY C� OTHER <br /> FINISHED FLOOR ELEVATI4NS �� F1.00D ZONE AREA QYES NO <br /> (�� f} /I <br /> BUIIDER �COMpANY <br /> /t�S�G�� Ftd/�4� �I.Ul��� <br /> / <br /> SIGNATURE � �C� REGIS7ERED Y/ N FEE CURRE� Y/N <br /> Address 7��a �„i+��. ,� �Q�/� Z= h /�1�e115 �� 335"+fl License# � �� <br /> ELEC'tRtClAtd GOMPA�IY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> PLtlMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CUF2RE� Y/N <br /> Address License# �- � <br /> MECHANtCAI. � ' COMPANY <br /> SIGNATURE _�� REGIS7ERED Y/ N FEE CURREP Y/N <br /> Address license# �- � <br /> 4THEl2 COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �� � Lficense# � ��- - - M` <br /> RESlDEtdTiAL Attach{2}Plo#Plans;{2}sets af 8uilding Plans;{9)set of Energy Forms;R-O-W Perm�t far new construction, <br /> Minimum ten(10)working days after submfttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fenae instaUed, <br /> Sanitary Facilides&1 dumpster;Site Work Permit for subdivisionsAarge projects <br /> COMMERGIAL Attach{3}camplete se#s o#Bu[lding Plans plus a Ufe Safety Page;{1}set of Enerc,�y Forms.R-C?-W Permit for new const�uction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Canstructlan Plans,StoRnwater Plans w/Spt Fenae installed, <br /> Sanitary Facilities&1 dumpster:Site Work Permit for all new proJacts.AI!commercial requirements must meet compliance <br /> SIGN PERNIIT Attach{2}sets of Engtneered Plans. <br /> "'"PROPERTY SURVEY required for all NEW constructlan. <br /> Directions: <br /> Fiil out application completely. <br /> Owner&Cantractor sign back of applfcatton,notarized ; <br /> tF aver a2500,a Nattce of Commsneement is reguired. (AtG upgrades over ST58d) .. <br /> " Agent(for the contractor)ar Power of Attomey(for the awner)would be someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER PERMiTTiNGr:.,_,.:-.{Front af•;4ppli�aiSqn'Oniy}<�,;'.� ,+._ ..�......4._ __._;:. `...- _ ,..._ --�..�. _ ,� <br /> Reroofs if shingles Sewers ' Service.Wpgrades_A/C: Fences(PIoUSunrey/Footage) . . , , „ - , ` <br /> . , >r � . . ; <br /> t � - : � . � � r <br /> Driveways-Not over Counter if on putilic roadways..needs ROW . ' , , ' <br /> � <br />