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813-�so-oo2a City of Zephyrh�lls Permit A plication Fax 813-7aa <br /> Buitding Departman# p �` <br /> . � <br /> Dake itecetved �-pr '�D( � Phone,Cantact f r RermittU — <br /> 0 <br /> Owner'a'Name Y� ^ I Owner Phone Namber �' <br /> Owner'�Address � a tJ�7 � 1'' Owner Phona Number � —� ' <br /> Fee Simple Titleholder Name �� � � Owner Phone.Number � —� <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ���U✓�-�Z. LOT# ��� <br /> SUBDiViSION �� � PpRCE�Iq# <br /> �� (OBTAINEO FR�O`M PROPERTYT�nce)DEMOIISH <br /> WORK PROP03ED NEW CONSTR ADD/AL SIGt3� <br /> �. INSTALL 8 REPAIR <br /> PROPOSED USE � SFR � COMM � QTNER <br /> TYPE OF CONSTRUC'T10N �] BLOCK Q FRAME C� STEEI. Q <br /> DESCRiPTION OF WORK ��� i J t J�) �- �•''ti�l-- 5��,,b C ,Ll((_._, � <br /> BUILDlNG SIZE �� � SQ F007AGE HEIGH7 C�_---_+� , <br /> ���{�'d��fi' �"����� VALUA710N oF TOTAI.CONSTRl1CTION <br /> L� <br /> QE�ECTRiCAI. $ AMP SERV1 E Q P320GRESS ENERGY Q W.R.E.C. <br /> I QPLUMBING <br /> ' �,..- � � � <br /> QMECHANlGAL $ VAIUATlON F MECNANICAI.INSTAI__LATION �� <br /> �c�s o RaQ����. o sQ�ci �nr [� OTHEi2 <br /> ��� f�b�'�l <br /> FINISHED FLOOR ELEVATI4NS �� FLOOD ONE AREA �]YE$ NO J,�11,�� <br /> I "( �� <br /> i <br /> BUtCDER {�!� �� CO PANY #�I��+. • �C� <br /> SIGNA7URE U ti' � REG STERED Y/ N FEE CURRE� Y/N. <br /> Address �� ' � ciJ3�n. {a�, � �i �- Cicense# �� � <br /> ��5,{� � <br /> , E�EC'fRICtAW CO PANY <br /> SIGNATURE REG STERED Y/ N FEE CURRE� Y/N <br /> Address � L(cense# r� � <br /> PLUMBER � CO PAN1! <br /> SIGNATURE REG S7ERED Y/ N FEE CURREA Y/N <br /> Address License# � � <br /> MEGFiANICAL �p p�(y <br /> , SIGNATURE REG STERED Y/ N FEE CURRE� Y/N . <br /> Address License# � �� � <br /> , OTHER CO IPANY <br /> � SIGNATURE ' ReG STe�� Y/ N �ee Cuatx�n Y/N <br /> Address � License# � � <br /> i <br /> RESlDENTIAL Attach{2}Ptat Pians;.(2)sets of.Buiiding Ptans;{1)sef �f Energy Forms;R-O-W Permlt Ear new consfnsctlon, <br /> Minimum ken(1.0)•working days,after submittal date. R uired onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> SanitaryFaciliUes,&-1.dumpste_r,.SiteWoric�P.ermitfors bdlvislons/largeproJects. ' <br /> COMMERCI�U. Attach{3}complete sets°of Su3ldingPlans ptus a Ltfe S �fety Page;{1}se#af Enet�gy Fazcns.R-O-W Permit for new c;anstructtan. <br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles 8 1 dumpster.Site Work Pertnit for al new proJects.Ail commercial requlrements must meet campllance <br /> StGN PER�11't Attach(2)se#s af Engineered Plans.;.. <br /> "`"PROPERTY SURVEY required for all NEVU conshu on. <br /> plrectfons: ' <br /> Fill out application completely. <br /> Owner&Conkractor sign back of appltcaUon,notarized <br /> If aver�2500,a Notice of Cammsncement is required. (AtC upg des ovar$7500) <br /> `" Agent(for the contractor)ar Power of Aftomey,(fcir ffie''owne�)�wbuld;ti �someone with notarized letter from owner authorizing same <br /> OVER THE CClUNTER RERMITIING {Front ot AppllcatJon Orily)� "' <br /> Reroofs If shingles Sewers �4 Service Upgrades A!C. . Fences Plat/Survey/Footage) <br /> Driveways-Not over Caunter tf on publiainadruays.:neeii"s`ROW��"�° °�' <br />