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813-780-0020 City of Zephyrhills Permit Application Fax-813-784-0021 <br /> Building Department <br /> 4`., <br /> Date Received Phone Contact for Permitting p� ✓ ��02` - �b L � <br /> Qwner's Name G-���/�/� �-�'/�2 l �" �U Owner Phone Number c5 J�, � -��v�� <br /> Owner's Address �� ��J"� /e3 c�i/�, f�-2>� � ��� Owner Phone Number �^ � <br /> Fee Simple Titieholder Name �— � Owner Phone Number � � <br /> Fee Simple Titleholder Address <br /> JOS ADDRESS ��� J�j� � { �.°' �z�l�L.�S,, /�� • ���'�� LOT# � <br /> $UBDTVtS10N �^ � PARCELID# J� �� �f ��ed� Q�.�e�,� � ��`� <br /> (OBTAINEO FROM PROPERTY TAX NQTICE) <br /> WORK PROPOSED e NEW CONSTR� ADDlA�T � SIGN {� Q DENIOLISH <br /> INSTALL REPAIR <br /> PftOPOSED USE Q 8FR Q COMM Q OTHER <br /> TYPE OF CONS7RUCTION Q BLQCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �-.�J�I� 9� �G' �G�..L'� •'��� <br /> BUI�DlNG SIZE �^ � SQ FOO7AGE�__�� H81GHT ��� <br /> Og���p�N� L'_____� VALUATION OF TOTAL CONSTRUCTtON <br /> �rl <br /> QELECTRICA� �; � AMP SERV(CE 0 PROGRESS E�IERGY Q W.R.E.C. <br /> QPLUfu1BING �$>�� � <br /> L <br /> QMECHANICAL. $ ��r.,��' �� VRLUATION QF MEGNANIGAI.tNSTA�tATIQN l{QO� <br /> � <br /> �GAS Q ROOFING Q SPECIAITY � 4THEFZ <br /> FINISHED FLOOR ELEVATIONS L�� FLOQD ZONE AREA QYES NO <br /> 8iJ1CDER �pMpp,�+ <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— � <br /> Ei.EC7RICIAF! �� COMPANY <br /> SIGNATURE _ REGIST�RED Y/ N FEE CURRE� Y/N <br /> Addrsss License# �— � <br /> P1.UNtBEi2 CONIPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �` � <br /> MECHANICAL - � ` COMPANY ��'lf1� � PD A�tt1� C�S � �j{�'/� • <br /> SIGNATURE � '� �- �~,���"�- REGISTERED Y 1 N FEE CURRE� Y J N <br /> Address ��'�3�����211� �7'c�g. -��.¢,+��.j �•'?.� License# ��a_�.�`�� eS � <br /> OTMER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— � � <br /> RESIDENTtAL Attach(2}Piot Plans;{2}sets of Building Pians;{i)set af Energy Forms;R-t?-W Perm�#for new co»struction, <br /> Minimum ten(10j working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facil(ties&1 dumpster;Site Work PeRnit for subdivisionsflarge projects <br /> CQMtUlERC1AL Attach{3)compfete sets of 8uilding Plans plus a Life Safety Page;{9}set af Energy Forms.R-O-W PErmit for new construction. <br /> Minimum ten(10}working days after submittel�date. Required onsfte,Construction Plans,Stortnwater Plans w/Silt Fence installed, - <br /> Sanitary Facilltles&1 dumpster.Site Work Permit for al!new proJects.Ap commercial requirements must meet compliance <br /> StGN FERM17 Attach{2}sets of Engineered plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> 3irections: � <br /> Fill out application completely. ;- <br /> Owner 8�Contrector sign baok of application,notarized ; � <br /> If aver 52544,a Notice af Commencement is requFred. ;(AtC upgrades over�TS00} r <br /> '" Agent(for the contractor)or Power of Attomey(for the owner)would be s"omeone with notariaed letter from owner authorizing same = , <br /> �VER THE COUNTER PERMITTING {Front of Application Only} ' ` 1�' �' <br /> 2eroofs If shingles Sewers , - Senrice Upgrades�A/C �Fences(Plot/Survey/Footage) _ _ <br /> ; „ , <br /> Driveways-t�tot over Counter if on piabtio roadways..needs ROW� � � - � , � <br /> ,� _ . ,- , <br />