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s�s-�sa-aoao City of Zephyrhills Permit Application Fax-813-78d-Op21 <br /> Building Department <br /> Date Received:= Phone Contact for Permitting — <br /> Owner's Name 4...0 � �p7NG1� ��S� Owner Phane Number <br /> Owner's Address G� �T l ll�� � Owner Phone Number � � <br /> Fee Simple Titleholder Name � � Owner Phone Number � � <br /> Fee Simple Titlefioider Address <br /> JOB ADdRESS lv��lT��!� LOT# �_._� <br /> SUBDtVIS10N �It>>I�,� fiJ/�l-f' � PARCE�IQ# 4�:.�-�l-r t91�"�-•dpfJ�7- �L� <br /> (OBTAINED FROM pROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CON5TR 8 ADDtA�i' �� SiGN Q Q DEMO�ISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR O GQMM � OTHER <br /> TYPE OF CONSTRUGTiON Q BLOCK Q FRAME �� STEEL Q <br /> DE3CRIPTiON OP WORK � �9Ao� Q Gli��r L�II�� /� rJ� � J��* ��Jr��L .S}/I`/.CfiC� <br /> BUIl.DtNG SIZE �� � SQ FOOTAGE�� HEIGHT ��� <br /> �B���Q��G � � "` VALUATIOR!OF T4TA�CC}hISTRUCTION <br /> [�ELECTRICA� $ AIt�P SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBlNG � � <br /> ,...., c�� <br /> QMECHANICAL $ VALUATIQN OP MEGNANtCA�INSTAILATIQN �iU� <br /> � <br /> QGAS ROOFING Q SPEGtALTY � OTHER <br /> FiN15HED FLQOR ELEVATIQNS �� FLOOD ZONE AREA [�YES NO <br /> BUf�DER COMPANY <br /> SiGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N <br /> Address ticense# � � <br /> ELECTRlCtAN ' CONtPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C� � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � License# � � <br /> MEGHANIGAI. �p�ypl,wy <br /> SiGNATURE , REGI57ERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> StG ATURE �_,,,. COMPANY �f��/1� �plO.�fJ��' <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �� � � ,.3 ,�/f�j1�` �G�1 �L License# �pZ ,'.�� � <br /> RESlDENTIAL Attach{2)Plat Plans;{2}sets of Buifding Plans;{1)se#af Energy Forms;i2-Q-W Permit for new construc6on, <br /> Minimum ten(f0)working days after submittal da#e. itequired onsite,Constructian Ptans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Perm(t for subdlvisfons/large projects <br /> CQMMERCiAL Attach{3}camptete sets of Buitding Plans plus a i.ife Safeiy Page;t,1}set o#Energy F��ms.R-O-W_Permlt for new constrvction. - - - _ - � - <br /> , Minimum ten(10}working days after submiktai date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence lnstalled, r <br /> Sanitary Facilities&1 dumpster.Site Work Pertnit for all new proJects.All commercial requirements must meet compliance <br /> StGN PERMIT Attach{2}sets of Engineered Plans. <br /> "**PROPERTY SURVEY required for all NEW construction. <br /> Direatians: <br /> Fltt out apptication completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> tf over�2500,a Notiae of Commencement is requir$d. (A!C upgrades over�T500j <br /> '" Agent(for the contractor)ar Power of Attomey(for the owner)would be someone with notarized letter from owner autharizing same <br /> dVER TME COtlNTER PERMITTING:, - :{Frontof�Application Only} .�.-µ. ._.. _ , ._ _..x� �..: _.... ._. - <br /> Reroofs if shingles Sewers � Senrice Upgrades i4/C ,.Fences.(PlobSurvey/Faotage) � - � - � - - , <br /> } � �� , , -„ r .�. _.,. . � _ • . , <br /> ;'L - �'k <br /> Driveways•Not over Counter if on pu6l3c roadwa}rs:.rieeds ROVtt:.. _. ._ ._ �. _- <br /> • ., „ ,.. ,�. .,. . , .. „ . ...,,_ , �, ..,,. .. , <br />