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8�saao-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> w Buiiding departmenf <br /> Date Received Phone�Contact for PermlttEn <br /> Owner's Name•:+�:.> ,r.. ,,`�l�y� �" � V�� Owner Phone Number ��� .��� ���� <br /> Owner's`Addre�s;; �°�'/�+'7(7 g� 1,��'�� �,���d L�`�� Owner Phone Number O�-�_ � �� � ��S <br /> Fee Slmpls'Titleholde�r•Name.,.�� ° � Owner Rhone Number � � <br /> Fee 3lmple Titleholder Address <br /> JOB ADDRESS � l ��� /,�" ll ��p�� ��� LOT# C�„� <br /> SUBDMSiQN � . � PARCEL ID# j �j ��p� ('�� ��"�G?!�t�C�R�p2 f.�D <br /> (OBTAINED FRQM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEw CONSTR ADDtAC.T � S{GM1t C] [� DEMO�ISH <br /> ' INSTAL,L F2EPAIR <br /> Pi2CIPQSED USE Q 3FR � COMM [� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK [� FRAME C� STEEL Q <br /> DESGRIPTiQN OF WORK i7�� ��CI� � jt�(r L e <br /> BUILDlNG SiZE � � �f�FOOTAGE Q HEIGHT �-� <br /> �B�«����'' � �(�j � VALUATION OF TQTAL CONSTRUCTION <br /> �'�� <br /> QEt�ECTRICA� � � AMP SEFtVICE Q Pi20GRE5S ENERGY Q W.R.E.C. <br /> OP�UMBIN{"'s $�--�—'. � �,�'���► <br /> � <br /> OMECHRNICAI ($ � � VA�UAl'tON OF MECHANICA�INBTALLATIQN <br /> � <br /> QGAS Q RQOFING Q SPECtAl.TY C� QTHEE2 <br /> FINISHED FLOOR ELEVATIONS �--� FLOOD ZONE AREA QYES NO <br /> „ „ , ...�'"".��- „ <br /> su�t���� � - coM�� ��'.rl�' G 1'f7 v��'7 - - <br /> SIGNATURE REGISTEREGI Y/ N FEE CURRE� Y/N <br /> Address Ucense# � � <br /> E�ECTRlClAN COMPANY <br /> SIGNATURE REC.yISTERED Y/ N FEE CURRE� Y/N <br /> Address Llcense# �� I <br /> PCU[tii68EFt � CQMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre�s license# � � <br /> MECHANICAC CAMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Liaense# � � <br /> OTHER COMPAt�IY <br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y/N <br /> Addre�s � _ LEcense# �— � <br /> RESIOEN'f1AL Attach(2)Plot Plans;{2)sets af;Buitding Plans;{1}se#oF Energy Fartns;R-O-W Permlt for new consUvctian, <br /> Minimum ten(10)working.days after.submlttal date. Required ansite,Constructlon Plans,Stormwater Plans w/Siit Fence installed, <br /> San(tary Facilities,&--1,.dumpster�Site�Wo�lc Retmit for subdivisionsAarge projects � <br /> COMMERCIA� AttacE�{3}complete sets o#Buildirig Plaris pius a life Safety Page;{1)set of Energy Forms.Ft•O-W Permit tor new constructEan. <br /> Minimum ten(10)working days'after submittal date.'Required onsite,ConsUuction Plans,Starmwater Plans w/Silt Fence installed, <br /> Sanitary FacAitles 81 dumpster.Site Work Permit for all new prajects.A!I commercial requirements must meet compliance <br /> SIGN PERMIT Rttacli{2)sets af Eogineered Plans.. ( <br /> "«•"PROPERTY SURVEY required for all NEW construcdon. <br /> DireatEans: <br /> Fill out application completely. <br /> Owner&Cantractor sign back of appfCcaUon,notarfzed , <br /> if aver�2500,a Notiae af Cammenaement ls required. (A/C upgrade�over 57500) <br /> " Agent(far the ciintractor)or Power of Attomey(for the owner)would 6e someone wlth notarized letter from awner autho�izing same <br /> OVER THE COUNTER.PERMITfIPlG (Front af Application Ctnly} <br /> Reraafs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Nok over Counter if on public roadways..needs ROW <br />