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s�s-780-0420 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Buiiding Qepattment <br /> �+�_ . - <br /> . � <br /> Date Recelved �Phone-Contact for Parmittin - <br /> Oyrner's Name p ( ti!ni r G, Owner Phone Number � �J2 �3�('� � <br /> Owner's Address � I r Z (2�' S-�r�e � 2�. Owner Phone Number � °: � <br /> Fee 5lmple 7ltleholder Name �— � Owner Phane Number � <br /> Fee Slmple 7ltleholder Addre�s - <br /> JOB ADDRESS LOT# � <br /> SUBDIVISION �— � PARCEt,iD# <br /> (OBTAINED FR4M PROPERTYTAX NOTICE) <br /> WORK PRflPOSED NEW CONSTR AODlA�T � SiGM1! [� Q DEMfl�ISN <br /> � INSTAL4. REPAIR <br /> PROP4SED USE � SFR � GOMiVI Q OTHER <br /> TYPE OF CQNSTRUGTION Q BLOCK FRAME C� STEEI. Q <br /> DESGRIPTIdN OF WORK �I f �i ' <br /> BUiLDltVG S1ZE �� � 8Q FOOTAGE " HEiGHT �� <br /> ���=�'d�NC`' $ , ZS(� „��� VALUATION OF TOTAL COiVSTRUCTION <br /> Q � � AMP SERVICE Q PROGRESS ENERGY Q W.t2.E.C. <br /> EI.ECTRICA� $ <br /> OP�UMSING �;6� <br /> � ������ <br /> QMEGHANtCAL $ VAl.UAT14N OF IVIECHANICAL It�1STALlAT10N <br /> QGAS � FtOQFiNG Q SPECIAI.TY Q OTHER <br /> FINISHED F1.00R ELEVATIONS �� FLOOD ZONE AREA QYES NO <br /> ,,, ,_._ .� <br /> BUt1.DER \ � � J CQMPA�IY �f%tJ���- <br /> SIGNATURE �..,�t�� .J"l CrR;/ ( REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Gcense# � � <br /> ELECTRICIAN CBMPAiVY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# { � <br /> PLUiV1BER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre�s license# �� � <br /> MECFfAtrtlCAE. COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address license# � � <br /> OTNElt COMPANY <br /> SIGNATURE � REGISrEREp Y/ N FEE CURRE� Y/N <br /> Address � license# �� � <br /> RESlDEFlTIAL Attach{2}Plot Plans,{2}sets.of Butlding`Plans;{1}set of Eriergy}Forms;R O-Vit Permlt for new construation, <br /> Minimum.ten(1Q)worlcing,days after."submlttal date. Requlred onsite,ConsUucdon Plans;Stormwater Pians w/Silt Fence instailed, <br /> � Sanitary Facilides.8.1�dumpste,r,Site�Worlc:Permit for subdiVisiq�sAange projects � <br /> GONiiVtERG1Al. A#tacb{3)complete sets of Bu11ii1ng Pians plus a Ll#e Safety Page;{1}set of Energy Forins.R-O-W Perm9t for new canstruc#ion. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construcdon Plans,Stormwater Plans w/Silt Fence installed, _ <br /> Sanitary Faciii8es 81 dumpster.Site Work Permit for all new pro)ects.All commeccial requlrements must meet compliance <br /> SIGN PERMiT AttacFi{2}sets af Eiiglneered Pla�s.�, . <br /> •""'PROPERTY SURVEY requlred for all NEW c:onstnact(on. <br /> Dlraatlons: ' <br /> FIII out applicatian completely. <br /> Owner 8�Contractar sign back of applicatton,notarized <br /> If over 52500,a Notice of Commencement is required. (AtC upgrades over 57540) _- _ _ � . , _ . . _ _ <br /> " Agent(for tlie cnntractor)or Power of Attomey(for tlie qwner)would be someane with nota�ized letter from owner authorizing same � , .. <br /> OVER Tf�tE COtlNTER PERMTiTING `� �`'(Fronfof Appiicaticn Only} � <br /> Reroofs lf shingles Sewers Seroice Upgrades AIC Fences<(Plot/Survey/Footage) . .. <br /> Driveways-Not over Counter.if on pubiic roadways..naeds ROW T :. <br />