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a�s-�so-oaao City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Bu8d9ng Department - <br /> Qate Received_-- _��._,:_ :-�:.�,l��,....,....,..... ..y ► + , ;�!_�, -rf-��„�- �. <br /> / Phone Cantaet for Permittin�' I <br /> Owner's Nas►ae. '�, - ,'4!=f' C)�� `Ownsr Phone Number �G. � : 6.�..� �� <br /> Owner's Address �� ��~6 v � �OI_e_J do �d�/� �Owner Phone Number �= � <br /> Fee Simple Tltlehalder Name r� � Owner Rhone Number � � <br /> Fee Simple Titlehalder Address <br /> JOB ADDRESS ._..J�'G�C� G �` t9 Gc.,l p � G7 a/� LOT# �� <br /> SUBbIVIS10N � � PARCE�ID# <br /> (OBTAINED FROM PROPERTY TAX'NOTICE) <br /> WC1RK P1tOPOSED NEVtt CONSTR ADD/AI.T [� SlGN [� C] DEMC}LISH <br /> � INSTALL 8 REPAIFt <br /> PROPOSED USE � SFR Q COMM [� OTHER <br /> TYP6 OF CONSTRUCTION Q BLOCK C] FRAME � STEEI, Q <br /> DESCRIPTION OF WORK ��'�'�/I� � rX j4,�.����D �' <br /> BUILDING S1ZE � � 8Q FOOTAGE� HEIGHt ��—� <br /> QBUIIDiNt3 $ ��p�dr3�.-� VALUATIOP!OF TOTAL CONSTRUCTION <br /> G y� <br /> QEt�ECTR1CAl $ --r � AMP SERVICE Q PROGRESS EhlERGY Q W.R.E.C. <br /> /�J�-+ ►�C"�Q �d�'Lt._45� �\� � <��� (�� <br /> QP�UMBtNG $ � r�'r- p U t��--�° �+� � V <br /> �� .l`�j � {•th.-�4 i!�I ,S b� <br /> ! p <br /> QMECHANICAL $ V,LUA�ON�OF MECHAN CAL ENSTAL�T ON� ! �"�,, � <br /> � ���('�,�, � <br /> QGAS Q ROQFlNG_ Q SPECIA�TY Q OTHER �'+'r%'� <br /> FINISHED FLOOR El.EVA710NS �--� FLOOD ZONE AREA QYES NO � �/�,��� <br /> ��r <br /> Bu��o�� ��c--��,� CC}MPANY � a w�2 Q�;2 E'e� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres� Ltcense# �— '—� <br /> E�ECTRtClAN COMPANY <br /> SIGNATURE REGISTEREd Y/ N FEE CURRE� Y/N <br /> Address Ucense# �` I <br /> i <br /> P�UMBER � CCt0i1pANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> MECHANiGAC COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address' License# � � <br /> OTHER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre�s � Ucense# �- � <br /> RESIDENi'!Al Attacfi{2}Pla#Pla�s;{2}sets of:Bullding Plans;{1)set af Energy Farms;R-O-W Pemilt for Rew consttuc6an, <br /> Minimum;ten.(10):.working days after,submittal date: Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed, <br /> 3anitary Facilikies&1.dumpster,Site Work Permit for subdivislonsAa�ge projects <br /> GOMMERCIAL At#ach(3}compiete sets of Builiilrig P1ans plus a Ltfe Safeiy Page;(i)set of Energy Forms.R t)-W Psrmtt for new construction. <br /> Minimum ten(1 q)working days'after su6mlttal date. Required ansite,CansUuction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanikary Facllitles&1 dumpster.Site Work Permtt for a0 new proJects:.All commercial requlrements must meet compllance <br /> StGN PERMIT At#ach{2)sets of Erigineered Plans. <br /> ""'PROPERTY SURVEY Fequired for all NEW construcUon. <br /> Dlractions: <br /> Fill out applicatian completely. <br /> Owner&Cantractor stgn back of applicadon,notarized <br /> tE over�2500,a Natice of Gammenaement is reguired. {A!C npgrades aver 57500} <br /> " Agent(for the contractora or Pawer of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER TFFE COUHTER PERMITTIFtG (Front of Applicatian Only} <br /> Reroafs if shingles Sewers Service Upgrades A/C Fences(PIoUSurveylFootage) <br /> Drivaways-Nat over Caunter if an pubiic roadways..needs F2QW <br />