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a�s-�aa-oazo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building pepartment <br /> Date Raceived , - Phone Gontact for•Permtttin - — � <br /> Owner's Name,�.i. _ _ Owner Phone Number <br /> . . � . .�.-........a ar.,o.._w�b•b-:.f.—•: +a`e... � <br /> ',; . � r , , c .�....3_.. - .. . '��� � .,.�...�r :�r . i.v� ..JI aY: <br /> Qwner's Addres`s" - � ��;' ,. „�� ,, • � :Owner Phon�.Number�'t�- � <br /> � �;s „ .., .. ,_ _ �{ <br /> Fee Simpte Tltieholder:Name�. __� � 1 �3 }, '�� �+µ •' �`(�- L�' ` � I <br /> x: <br /> ,., ... ,... . , _ _ <br /> , � - <br /> �Owner Phorie�Numb'er'�',�..__..��4 <br /> _ _,. ....... � , _.9.�.�- -.:��,, <br /> Fee Simpie Titieholder Addre�s <br /> JOB ADDRESS L.OT# �� <br /> StlBDtVtS10H � ' �� PARCEl1D# <br /> -- '-- -- ' -' -,--_ -'-_ -- ----(OBTAINEDFROh9-PROPER7'V-TAX-NOTICE) <br /> WQRK PROPCtSEQ NEW CONSSR iRDDlAIT' Q StGN Q � Q DEMQUSN <br /> INBTALL 8 REPAIR � ' � <br /> PROPOSED USE Q `SFR � Q COMM �� OTHER <br /> TYPE OF CONSTRUC710W Q BLOCK Q , FRAME � STEEL Q. <br /> DESCRIPT10N=0F WOtttC <br /> BUtLDING SIZE �� � SQ FOOTAGE��].. NEIGHT �� <br /> QBUlLptNG �>--� -VA�UATION OF TOTAL CONSTRt1GT'ION , <br /> [�ELECTRICAk. $ ° �� : �AMP SER�IICE Q PRO{3RES8 ENERC3Y �Q W.E2.E.C. <br /> � � �� ' <br /> QPLUMBWG $ <br /> ��______�, . <br /> QMECNANfCAI. ($ ------� VALUATION OF MECHANICA�iNSTAi»tATiON <br /> � <br /> QGAS Q RpQFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVAT�ONS � FLOOD ZONE AREA QYES NO <br /> BUILDER COiVIPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> ����5� License# �— � <br /> E�ECTRtGlAN- . - . GOMPANY . <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/'N ' <br /> Address lfcense#•�— „ � <br /> P�UNiBER .. COMPAHY � <br /> SIGI+IATURE �REGISTERED Y[ N �E curtRE�� Y/.N <br /> Address �_ License# � � <br /> MECHANIGAL � � COMPANY <br /> SIGNATURE ' ± ' " , RE�iSTEREO ..Y! N FEE CURRE�, . Y/N� <br /> Address � . � License.#..�— �� <br /> QTNER � . CQMPANY ' � <br /> SIGNATURE ' � - � REGISTERED � Y/ N . FEE CURRE� Y/N, <br /> Address -- � � � - - ' ` I:icense# � � <br /> RESIDENTlAL:. . �-Attach{2�Plot Plans;.(2),sets�,of.Buitd'+iig!P..lans;(1}set of Energy Foims;R-0=1tV�Perenit for new cx�hstruation, <br /> Min3mum#en.(,1fl}..wocking,day,s�after:submittat dafe:;;Requir�eii onsite,Cons#ruction t?lans;StoRnwater Pians w/5(it Fence installed, <br /> � Sanita'ry Facilitles&�1 dumpster;Sike•Work�Permit farsubdivisfonsllarge projects�, � <br /> COMMEFtCIAL Attach(3}�coinpiete sets of Buifdfrig Plans pitis a Life Safety Page;`(1)se#af Energy Forms.R-Q-W Perm9t for new cons�uc�on. <br /> Mirrirnum ten(10}working days after submlttai date. Required onsite,ConsUvction Plans,Stormwater Plans w/Silt Fence i�stalled, <br /> Sani#ary Facilitles 81 dumpster.Site Work Perm(t for all new..proJects:�All�commerolal requirements.must meet compliance <br /> SIGN PERMIT Attach(2J sets'of Ertgfneered;Plans.._ ;.: � � _ - <br /> ""PROPERiY SURVEY required for`a(I NEW construction. <br /> �Ireclions: - : <br /> Fit!aut.applica8on completely. <br /> Owner&Gontractor sign back of applfcation,notarized <br /> !f over�25Q0,a Natice of Commencement Is requiree3. {AtG upgrades over ST5d0) <br /> " Agent(for the contractor)•or Power nf Attomey(forthe�owner)would'be sort^ieone with notarized letter from owner authorizing same <br /> �VER TNE COUNfiER PERM17'FlNG_ .,,_„{Front ot.Applfcafion..On1y} . � <br /> �eroofs if shingles Sewers 5ervice Upgrades A1C Fences(Piot/Survey/Footage) <br /> e - . .. <br /> Drtveways-Not over Counter if an pubtic roadways:rieeds ROW � � <br />