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Q,�-rp�-���U Gity of Zephyrhills Permit Applica#ion Fax 813-78U-0021 <br /> „ Buiiding departmant <br /> rl . <br /> Date Recelvad � �3 ��� Phone Contact for Permittln <br /> Owner's Name �� �B.d Owner Phone Number �f���� <br /> Owner's Address (� ��� W 'lL.� � t3wn�r Phone Number <br /> Fee Simple T!tleholder Name � i Qwner Phone Nurnber � <br /> Fee Slmple Titleholdar Address <br /> JOB ADORESS ��M �- LOT# �� <br /> SUBDNtSION r� � PARCE�.ID# <br /> (OBTAINEP FROM PROPERTY?AX NOTICE} <br /> WORK PROpOSED e NEw CONSTR 8 ADD/A�T � SiGN (� Q DEMOUSN <br /> tNSTALt REPAIR <br /> PROPOSED USE Q SFR Q CQMM [� OTHER <br /> 'fYPE OF CON5TRUC1'IOEI Q 81.QCK Q FRAME � STEE� Q <br /> DESCRIPTION OF WORK �� �- J '�/ T -� J� � <br /> BUILDING SIZE � � SQ FOOTAGE NEIGHT C___`__� <br /> �BUILDING �� VAtUAT10N OF TOTAL CONSTRUCTtON <br /> [�ELECTRICAL ($—�� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> � <br /> QPLUMBING �-� <br /> � <br /> �MECHANiCAL $ �/��-%O VALUATION OF MECHANICAL INS7ALLATION � ���� <br /> � <br /> QGAS Q ROOFING [� SPECIALTY � OTHER <br /> FINISHED FlOOF2 ELEVATtONS (��� FLOOd ZONE AREA QY6S NO <br /> L <br /> SUILDER COMPANY <br /> SIGNATURE REfi�iSTERED Y t N FEE CURRE� Y/N <br /> Address �^� `�` License# � �� <br /> ELEGTRICIAN � COMPANY <br /> SlGNATURE ( REGISTERED Y/ R) �EE CURRE� Y J N <br /> Address Ucense# �^ `�� <br /> PI.UMBER � COMPANY <br /> SIGNATURE REGiSTEf2ED Y/ (V FEE CURREt� Y/N <br /> Address License# �' i�'� <br /> MECHANiCAt �����R COMPANIf �!/r2�' �1L-° �^'L� Cr�d.s GI- C <br /> SiGNATURE REGISTERED Y( N FEE GURREf� Y J <br /> Address `�� License# �,��.f.,� 7 3�� <br /> OTHER COMPANY <br /> SiGNATURE REGISTERED Y/ N FEE GURREr Y 1 N <br /> Address Llcense# � ` i� <br /> R6SlDENTIAL Attactt(2}Piat Pians;(2}sets of 8uilding Pians;(1j set af Energy Forms;R-O-W Permit for new canstruction, <br /> Minimum ten(1d}worlcing days after submtttat date. Required onsite,Construction Plans.Stormwater Plans w/Sllt Fence tnstafled, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivislonsflarge proJects <br /> COMMERCiAL Attach(3}compiete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Perm(t for new construc8an. <br /> Minimum ten(1d)working days after submittaf date. Required onsike,Construction Plans,Stormwater Pfans w/Siit Fe�ce instatled, <br /> Sanitary Facilities&1 dumpster.Site Work PermR for all new pro}ects.AlLcommercia!req�lrements must meet comptEance �__ _ <br /> SIGN PERMIT Attach(2)sets of Engineered Pians. <br /> ""PROPERI'Y SURVEY required for ali NEW construcdon. <br /> Direatians: <br /> ' Fitl ouf appticallon completely. <br /> Owner&Contractor sign back of appifcation,notarized <br /> If ovgr y2500,a Notice of Commencement ts requtred. {A!C upgradQS ovsr E75Q0} <br /> " Agent{for the conUactor}or Power af Attomey{far the owner}woutd be someone with notarized letter from owner authorizing same <br /> dVER THE COUNTER PERMITTING {Front af Application Only) ,. _ _ � , .,_, „ „t_ _, <br /> Reroafs if shingles Sewers Senrice Upgrades �AlC`;',"Fences(PlotlSurv'sy/Faotage} , _� . <br /> Drlveways-Not over Countar if on public roadways..neeiis RQW ' , � . , , , � <br />