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e�3-�eo-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> = � Buitding Department <br /> Data Recelved � �-� J Phone Contact for Permittin <br /> Qwne�r's Name �- �� c"�t �- �t ���k� Owner Phane Number <br /> Owner's Address j�a � � h .5 Owner Phane Number �— � <br /> Fes Simple Titieholder Name r � Owner Phone Number � � <br /> Fee Simple Tltieholder Address <br /> JOBADDRESS � 77�j� C�Dt�{ �tYi �-'rL�� t/ � LOT# E� <br /> SUBDIYISION Q�'�C RJ+� J�-���"�i_ � PAI2CEI.ID# <br /> (087AINED FROM PROPERTY TAX NOTlGE) <br /> WORK PROPOSED , e NEW CONSTR 8 ADDlALT � SIGN Q Q DEMOI.ISN <br /> INSTALL REPAIR <br /> Pi20POSED USE [� SFR [� COMM [� OTHER <br /> TYPE OF CONSTRUC7iON Q BLOCK [� FRAME [� STEEI. Q <br /> DESCRIPTION OF WORK tn5�*►�I t�e� ��.� j �,�,, .� A� �d .}� <br /> BUILDING SIZE ����� SQ FqQTAGE HEIGNT ��� <br /> QBUILDING �� VALtlkTiON{?F TOTAL CONSi'RUCTI{�N <br /> �ELECTRICAL ($ � AMP SERVICE � pROGRESS ENERGY Q W.R.E.C. <br /> � <br /> [�PLUMBiNG ($_� <br /> � <br /> OMECHRNlCAL ($.. � VALUATION OF MECHANICAL INSTALLATION <br /> E <br /> [�GAS [� ROOFING � SPECIALTY [� OTHER <br /> FIN4SNED F�OOR EtEVATtOM1IS ��� FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE ,_„i REGISTERED Y I N FEE CURRE� Y/N <br /> Address ��n�$# �— —� <br /> ELEGTRICIAN ��G������,��" COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address license# �� �� <br /> PLUMBER �� COMPANY <br /> SIG[+IATURE REGiSTERED Y J N FEE CURRE� Y/N <br /> Address License# ( � <br /> MECNAidICAt COMPANY <br /> SIGNATURE F2EGlSTEftED Y! N FEE CURREN Y/N <br /> Address License# �` � <br /> OTHER COMPANY <br /> SIfaNATURE RECsISTERED Y J N FEE CURRER Y J N <br /> Address License# � � <br /> RESlQENTIAi. Attach(2)Plat Pla�s;(2)sets of Building Plans;(1}set of Energy Forms;R-O-W Permit for new construcBon, <br /> Minlmum ten(10�wocking days after submltta4 date. itequfred onsfte,Construc�on P1ans,Stormwater Pians w/S31t Fence instailed, <br /> Sanitary FaGliUes&1 dumpster,Site Wa�ic Pertnit far subdivisionsAarge proJects - <br /> GOMNlERCIAL At#actt{3}camplets sets of Buildfing Plans pius a Life Safety Page;(1}set of Energy Forms.R-O-W Permit#or new construction. <br /> MfNmum ten{14)working days after submfttal date. Requfred onsite,ConsUuctton Pians,8tartnwater Pians w!Sit#Fence instatled, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compllance <br /> SIGN PERt�iT Attach(2)sets of Engineered Plans. <br /> '"""PROPERTY SURVEY requtred far ail NEW canstruction. <br /> Dtreatlons: <br /> Fflt aut application compietely. <br /> Owner&ContracMr sign back of appiicatlon,notadzed <br /> If over a2500,a Notice af Gommencement Is required. (AIC upgrades over E7500) <br /> " Agent(for the contractor}or Power af Attomey(for the awner)would be someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER PERMITI7NG (Front of ApplicaUon Only) <br /> Reroafs if shingles Sewers 8ervice Upgrades AJC Fenaes(PlotlSurveylFoatage) <br /> Drlveways-Not over Caunter if an public roedways..needs ROW <br />