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s�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date 6teceived Phone ConQact for Permitting p�3 � -- 3 � � <br /> �Oe�rner's Mame B�" Z ` ( D CHc � <br /> y r � S Ovuner F'hone�dumber <br /> mvvner's�ddress V', ` � O�nmer 6'hone Rlumber <br /> �ee SiPnple Titleholder fdame Owner Phone Rlumber <br /> _t� �fLf <br /> Fee Simple Titleholder Address CA(��" <br /> .DO�41DDRESS J — �-�i!�S ��- ,33 J/�'— LOT# � <br /> SID�DINISIOkI ��1RCEL ID# <br /> (OBTAIfdED FROAA PROPERTY TAX PdOTICE) <br /> lfHORCC PROPOSED NEW CONSTR ADD/ALT � SIGPV Q � DEMOLISH <br /> B INSTALL B REPAIR <br /> �ROPO��D USE Q SFR Q COMM 0 OTHER <br /> T1f�E OF COfdSTRUCTIOf� Q BLOCK � - FRAME � STEEL 0 <br /> ID�SCRIPTIOId OE Hl/ORK �fa x /3 <br /> �UI�.DIMG SIZE �o�, �C 3 SQ FOOT�►GE �Ll�p F9EIGHY <br /> OBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ao. <br /> QELECTRICAL $ AMP SERVICE � PROGRESS EiVERGY Q W.R.E.C. <br /> OPLUMBING $ ���2 <br /> d� ,3 �-�—P(�,,. <br /> QMECHAfVICAL $ VALUATION OF MECHANICAL INSTALLATIOIV � , <br /> ���� r <br /> �GAS Q ROOFING Q SPECIALTY 0 OTHER 3 �� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO i` �,� Q���/�c�:�jy�i <br /> �_q � ,.� <br />� �UILDER ���'S'� COAAPAIdY SG/i�,�S L`���'t'�� <br /> SIGWATURE REGISTERED Y/ I� FEE CURRE� Y/M <br /> 41t9dress License# � �b�c D �7 � <br /> �L�CTRICI�1fd COIIflPAWY <br /> S9GM�4TURE REGISTERED Y/ N FEE CURRE� Y/N <br /> �lddress License# <br /> ��lDRfiBE02 COAAP�4R9V <br /> 51G�Ut�Tl1PZE REGISTERED Y/ N FEE CURRE� Y/M <br /> e4ddress License# <br /> f1tI�CHAMICAL COiYiPAf�Y <br /> SIGRIATUltE REGISTERED Y I N FEE CURRE� Y/f� <br /> �►ddress License# <br /> OTHE6t COMPA,fdY <br /> SIG(dATURE REGISTERED Y/ N FEE CURRE� Y/M <br /> �dcdress License# <br /> R�SIDE(dTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Siit Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivfsions/large projects <br /> CORAAAERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> I Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> i Sanitary Faciflties&1 dumpster.Site Work Permlt for all new projects.All commercial requirements must meet compliance <br /> S9Gfd PERAIIIT Attach(2)sets of Engineered Plans. <br /> °"'PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,nota�(zed <br /> If over$2900,a fdotice of CoQnmencerv�ent is required. (?91C upgrades oeer$7500) <br /> •° Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> ONER YHE COUtdTER PERMIITTIR7G (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Drivearays-Not over Counter if on`putilic roadwaqs.:needs ROW � , ' �� � � ` � J � . <br /> ; _ , , �: ,.. ., � . <br />