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7 s,s-�au-�uzu City of Zephyrhills Permit Application Fax 813-780-4021 <br /> Building Depertment <br /> Date Receivad' �j f t�"'� one Contact for Permitting - <br /> Owner's Na ` Owner Phone Nucnber .� '' �►� ����� <br /> . �,3� � �„� f� ' � ` Owner Phone Number <br /> Qwner s Addre — <br /> Fee Simple Titleholder Name �� ,,,,_,� � Owner Phone Number �! �� <br /> Fee Simple Titleholder Address <br /> �o��aooR�ss �'l.� �G� G i. �LY� , �Hi�i�S LOT# Q <br /> j su�o�v�s�o� C� � PAl2CEL!D# �'�--�� ��-�a'��}�,e"����7 °t'l�,� <br /> (OBTAINEQ FROM PROPERTY TAX NOTICE► <br /> WORK PROPQSED e NEw CONSTR 8 ADDlALT �] SlGN � Q DEMC?LISH <br /> INSTALL REPAIR <br /> �� PROPOSED USE [� SFR [� CbMM �� OTHER <br /> � TYPE OF CONSTRUCTION [� BLOCK �] FRAME [� STEEL Q <br /> . �" �„ ' <br /> � DESCRIPTiON OF WORK f..C� /�� �! +$QI�T SO�a-�V � �✓ A,7�-- �"A � �� `� <br /> � BUI�DtNG SIZE � � SQ FOOTAGE�� HEiGHT [�.—� <br /> QBUI�DING � ���.�.,� �/AI.UATfON OF TOTAl.CONSTF2UCTION <br /> [�ELECTRICAL (9i� AMP SERVlCE Q PROGRESS ENERGY Q W.R.E,C. <br /> � � <br /> QPLUMBING $ �� ����f� <br /> l <br /> [�MECHANICAL $ VA4UATION OF MECHANICAL INSTALLATION �� ��2 K-- <br /> L/ <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER �} C�'""��� <br /> l_..' <br /> FINISHED FLOOR ELEVATIONS �_� FLOOD ZQNE AREA QYES NO <br /> BUILDER COMPANY <br /> SiGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> ., ..,_...,___�,_ <br /> Address License# � � <br /> � <br /> e+ <br /> , ELECTRICI �p��` COMPANY t�Rt Cr1 <br /> SIGNATURE -� W REGISTERBD Y/ N FEE CURRE►� Y/N <br /> Address License# �` � <br /> PLUMBER �� COMPANY <br /> SICCNATURE REGIS7'EREp Y/ N FEE CURRE� Y/N <br /> Address License# r— ' � <br /> � MECHANICAL COMPANY <br /> �, SIGNATURE REGIS7ERED Y/ N pEE CURREP Y/N <br /> Address Licen ��--i � <br /> OTHER iF���`�p�� � �COMPANY � <br /> SIGNATURE `� REGiSTERED N FEE CURRE� Y/N <br /> Address /�i�C'L�9�i��'���i� License# � � � <br /> i <br /> '_ R�SIDIER�TI�4L- - AFtach�2}P!ot P[ans;(�)sets of Huildir.g Plar.s;-(1)set of Ersrgy�Fa�s;R-Q-�"J Perni:for naw cans4ructio�r, �- - - - -- ---- <br /> Minimum ten{10}woricing days after submtttat date. Required onsite,ConstruccEion Plans,Stormwater Pians w/Silt Fence instailed, <br /> San(tary Facilttles&1 dumpster,Site Work Permit for subdlvisfonsAarge proJects - <br /> COMMERGIAL Attach(3)compiete sets of Buflding Plans plus a Llfe Safety Page;(1)set of Energy Forms.R-O-W Permlt for new consfruction. <br /> Minimum ten{10}working days after submtttal date. Required onsite,ConstrucHon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciUties&1 dumpster.Site Work Permft far ail new projects.Aq cammeraiai requlrements must meet campitance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURI/EY required for ali NEW construction. <br /> Directlons: <br /> Fiit out appiication completely, <br /> Ownet&Contra�tor slgn bacK of apptfcatlan,»otarized <br /> If aver 52500,a Nottae of Commencement Is required. {A/C upgradgs over�754Q) <br /> " Agent(for the contractor)or Power of Attamey{for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING {Front of Application Only) <br /> Reroofs if shingles Sewers Servlce Upgrades AiC Fences(PIoUSurvey/Footage) <br /> Drlveways-Not over Cuunkenif on public roadways..needs ROW <br /> , , , , + <br />