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o�3-,a�-���� Gity afi Zephyrhills Permit Application Fax-813-784-Od21 <br /> Buitdi�g Department <br /> L <br /> Date Reaeived one Contact for Permittin - <br /> Owner's Flame � .� t3wner Phane Number <br /> Owner's Address Owner Phcne Number � � <br /> Fee Simple Titiehotder Name �— � Owner Phone Number �� � <br /> Fee Simple Titieholder Address <br /> 3G1B ABDRESS LOT# � <br /> SUBDIVISION C� � PARCE�Id# <br /> (OB7A4NED FROM PROPERTY TAX NOTtCE) <br /> WORK PROPOSED e NEw GONSTR 8 ADDlALT C� SlGN Q Q DEMO�ISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OYHER <br /> TYPE OF CONS7RUCTION Q BLOCK Q FRAME Q STEEL Q <br /> ( /' <br /> DESCR1PT18N OF WORK Q°� L� <br /> BUILt}ING SI2E C�� SQ FOQTAGE HEIGFfT ��� <br /> �BUILDING $ -7r1� �� VA�UATION OF TOTAL CONSTF2UCTION <br /> lJ <br /> QELECTRICAL ($ — � AMP BERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �_ <br /> QPLUMBING � � <br /> QMECHANICAL �� VALUATION OF MECHANICAL INSTALIATION <br /> QGAS Q ROOFING Q SPECIAI.TY �� OTHER <br /> =1NISHEd FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> 3UILDER GOMPANY <br /> �MGNATURE ` f2EGISTERED Y/ N FEE CURRE� Y/N <br /> Addxess License# �—`� <br /> SLECTRICIAN COMPANY <br /> iIGNATURE REGISTERED Y/ (� FEE CURRE� Y/N <br /> Address Llcense# �^ ^� <br /> �L.UMBER � GOMPANY <br /> iIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �i���� <br /> �ECHANICAL GOMPANY <br /> i1GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ` Licensa# �— � <br /> 1THER GOMPANY <br /> �IGNATURE REGISTEFtED Y I N FEE CURRE� Y/N <br /> Address �� �Icense# �— �� <br /> ;EStDENTiAL Aftach(2}Plo#P�ans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W PeRnit for new constnaction, <br /> Mlnimum ten(14}wotking days after submittal date. Requlred onsite,Construction Pians,Stormwa#er Pians w/Silt Fence instatied, M^ _� <br /> Sanikary Facllities&1 dumpster,Sile Wortc Permit fo�subdivislonsAarge.p[o�ectF_ . -- ----- ----- -� � ,, �- <br /> OMME_RCIAI.._ _Attach-{3).c,4►rpplete sets•af Buitding�ian"s pius a Life Safety Page;(1)set of Energy Fonns.R-O-W Permit for new construction. � <br /> � Minimum ten{10)warking days after submittal date. Required onsite,Consttuction Plans,Stortnwater Plans w!Sllt Fence installed, <br /> San(kary Facllitles 8�1 dumpster.Site Work Permit for at!new projects.AA commerciai requirements must meet-comptlance� <br /> IGN PERMIT Attach(2)sets of Engineered Plans. ' � <br /> ***`PROPERTY SURVEY requirec!for alt NEW construction. . <br /> I�eatlons: <br /> Filt ouf apptication compieteiy. <br /> Chnmer&Gantracfor sfgn back of applicatlon,notarized <br /> If over S250Q,a Notice of Commencement Is required, (AIC upgradss over$7500) <br /> Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from°ov+mer authorizing same , <br /> VER THE COUNTBR PERMITI7NG (Front of Application Only� " � . ' ; <br /> eroofs if shingies Sewers Service Upgrades A/C Fences(PIoUSurveylFoatage) <br /> Drtveways-Not aver Counter if a�public roadways..needs ROW <br />