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�813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building bepartment <br /> ' . , <br /> Date Received � Phone Contact for Parmittin — <br /> Owner's Name L) (' 1 .J Owner Phone Number ��3� i j�`��'�� <br /> � r ��i� <br /> Owner's Address � i� Owner Phone Numbe �5a, '�J" rZ.,l — 9 <br /> Fee Slmple Titleholder Name � � Owne�Phone Number $�J "��7 —�7 o�J <br /> I <br /> Fee Simple Titleholder Address <br /> JOB ACIDRESS `3��50 �}t�' i i l s � �� �.or# �� <br /> susa�vis�o� ���+ � �aRC��r�# <br /> {OBTAINED FROM PROPERSY TAX NOTICE) <br /> WORK PROPQSED NEw GarasTR ADD/A�.T [�] SIGN Q [� DEMOLlSN <br /> , � INSTAI.,L 8 REPAI <br /> PRQPOSEp•U3E. � SFR C] COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � S7EEL Q <br /> DESCRIPTION OF WORif �l�D� I 15 �`7 <br /> � <br /> BUII.DING SIZE �� �� SQ.FOdTAGE�� HEIGNT �_� <br /> �UILDING $ <br /> L��/1 c3� VALUATlON OF TOTAL COi�1STRUCTION <br /> lJ <br /> [�ELECTRICAL ($ — �� AMP SERVIGE Q PRQGRESS ENERGY Q W.R.E.C. <br /> L� <br /> QPLUMBING ($�� � <br /> L_. ����� <br /> OMECHANICAL $ VALUA710N OF MECHANICAL INSTALLATION �� <br /> QGAS [� ROOFING Q SPECIALTY [� OTHER <br /> FIIVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NQ <br /> I � <br /> BUILDER �� COMPANY Ut�-l..° �WU�..!'' <br /> SIGNATUR� REGISTERED Y/ N FEE CURRE� Y!N <br /> Address � Cicense# �� i <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addrass � � License# � I <br /> PLUMBER � C IMPANY <br /> $1GPWTURE � REGISTERED Y/ N FEE CURREh Y/N <br /> i <br /> Address ( License# � � <br /> MECHANICAL CaNlPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> i <br /> aaa�Q�s L�ce�,se# �_ � <br /> ( <br /> OTHER COMPANY <br /> BtGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> I <br /> Address ( License# � � <br /> RESIDENTIAL Attach(2)Flot Plans;(2)seks of Building Plans;(1)set of Energy�Fortns;R-O-W Pertnit for new canskruction, <br /> Minimum ten(10).wc�rlcing;days after,submittal date. Required onsite,Gonstruction Plans,Storrnwater Ptans w/Silt Fence Installed, <br /> Sanitary Facilitles&:1.dumpster Sfte Warlc�Permit for subdivistonstlarge�proJects - <br /> COMMERCIAL Attach(3)camplete sets of Building'Plans plus a Ufe Safety Page;{1�set of Energyr Forms.R-O-W Permtt for new construckion. <br /> Minimum ten(10}working days'after submit#al date. Required onsite,ConsUucdon Plans,�tormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles&1 dumpster.Site Work Permtt far aii new projects.Ail commerciat requErements miast meet compiiance , <br /> SIGN PERMIT Attach(2)sets of Engirieered Plans.,. �• <br /> ""PROPERTY SURVEY required for aii NEW const ction. � <br /> Dlreations: <br /> Fill out applicatlon completely. <br /> Owner&Contraator slgn back of appiicatlon,,n,o,,,t�r�iaed <br /> !f over�250R.a Nottce of Commencement fs cequfred.;_:(AfC upgrades over ST50Q) : ,,,_ ,. <br /> � '« Agent(for the contra�tor)or Power of{Attomey(Ear ttie awner).would�be someone with notarized letter from owner auihorizing,same e <br /> QVER THE CQUNTER PERMITTING ' {Front of Application Only) ,. . ' _ ' . ; _ . <br /> Reroafsifshingles 5ewers SeriitiCbkJpgrades,A�C,,.,.,_,,,Fence's(Flot/Survey/Foatage) �' ' ` �, , <br /> Qrfveways-Not over Counter if on publkc roadways..needs ROW � f� <br />