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8�saeo-oozo City of Zephyrhills Permit Application Fax-813-78D-0021 <br /> Building Department , <br /> I�ate Receieec9 Phone Contact for Permitting ��'� . 7r6g -- Od \ <br /> Ouvner's fdame �q, ! P�.� .�,/t, v� �nrner Phone Idumber <br /> Owner's Address Ovdner Phone Number <br /> �ee Simple Titleholder Mame � O�nrner Phone Riumber <br /> Eee Simple Titleholder Address <br /> Jo��o���ss 3���� c;�...� Q �o�# p <br /> susDidisiob �A�c��io� c�3-26- \ -pp 30 - o <br /> (OBTAINED FRORA PROPERTY TAX NOTICE) <br /> lflI0Ed6f PROPOSED e NEW CONSTR B ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> _ �RO�OSEp USE Q SFR Q COMM � OTHER <br /> TV6'�OF COIdSYRUCTIOM Q BLOCK Q FRAME 0 STEEL Q <br /> D�SCRIPTIORI OF H!!OR!( „J.�K�h�` J �v•M�t� �V ��� S� vv� ` �uwti <br /> IBl71LDIfdG SIZE Sed FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> �LECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> 7C�U.J J <br /> QPLUMBING $ � � <br /> QMECHANICAL $ VALUATIOM OF MECHANICAL INSTALLATIOfV � <br /> � � <br /> � <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZOME AREA QYES NO <br /> I�IDI�.��R COl�9�AI�Y <br /> SIGIdATURE REGISTERED Y/ N FEE CURRE� Y/M <br /> Address License# <br /> IELECTRICIAM �� � � COMPANY 2.�2�i� ��`��'��G� . �G. <br /> �IG(dATURE �J REGISTERED Y/ PI FEE CURREP Y/N <br /> 64ddress (�C� 2 z - ( �. ti ' License# �� I�Dt�{3 S'� <br /> �LUMIBER CORAPAMY <br /> SIGM�►TURE REGISTERED Y/ M FEE CURRE� Y/M <br /> Address License# <br /> MECHAMICAL COMPAIdY <br /> SIGId6iTURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# <br /> O'�'HER COiNIPAfdY <br /> SIGRIATURE REGISTERED Y/ N FEE CURRE� Y/nI <br /> c4ddress License# <br /> fftESIDE1dTIAL 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;Cons'uuction Plans,Stormwater Plan"s"w/�Siit Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> CORAMIERCIAL Attach(3)complete sets of Buildfng Plans plus a Life Safety Page;(t)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.,Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGId PERAAIT Attach(2)sets of Engineereif Plans. • _., ' - .. , , _ <br /> "'"'PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Idotice of Commencernent is requlred. (A/C 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 /> O!/ER TIiE COUMTER PERfMI�'PING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlobSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />