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a�saso-oo2o City of Zephyrhills Permit Application Fax 813-780-0021 <br /> � Building Department <br /> , <br /> Date Received — � Phone Contack for Permitting – <br /> i Owner's Name ���� t-. �.'.JQ �r7 � Owner Pfione Number �1� -��--5���= � <br /> ,,. .,.. <br /> Owner's Address �`�"� ���� � 1 ll� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titlehalder Address <br /> JOS AbDRESS �� � � � � LOT# �� <br /> SUBDIVISSON ���-� � �G� �% PARCEL ID# <br /> (OBTAfNEG PROM PROPER71f TAX N0T4C�} <br /> WORK PROPOSED , � NEW CONS'TR 8 AQDlAI.T Q S{GN Q [� DEMOLISH <br /> INSTALL REPAIR <br /> PRQPOSED USE �, SFR � CQMM � OTHER <br /> 7YPE OF GONSTRUCTION Q BI.00K Q FRAME � STEEL Q <br /> DE$CRIPTIdN OF WORK �� PL� �}�ir��j 111 Ej �,�✓Y�-,�C��,S �-' �i���r'C� � �'�- <br /> BUILDING SIZE ��—� SQ FOQTAGE�� HEtGH3 �_� <br /> QBUILDING $ !,' D�U,tl `-` VAI.UAT{4N OF TOTA�CONSTRUCTION <br /> �} �0 <br /> QELECTRICAL ri� AMP SERV`ICE Q PROGRESS ENERGY Q W.R.E.G. <br /> L <br /> OPLUMBING ($�� ' y � � � <br /> � � r ( <br /> OMECHANICAI $ VALUATION OF MECHANICAL INSTALLATION ! � <br /> QGAS [� ROOFING Q SPECIALTY �� OTHER <br /> F�N�SHED FLQOR ELEVATIONS � � FLOOD ZQNE AREA QYES NO <br /> , <br /> BUILDER � COMPANY 'e � <br /> SIGNATURE Z REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � i� <br /> StGNATURE� � rt��spe� Y/ N FEE CURREI. Y/N <br /> Add�ess l.Icense# �`�� � <br /> PLUMBER COMPANY <br /> � S1{sNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# � � <br /> MECHANICAL COMPANY <br /> SIGPlATURE REGISTERED Y/ N FeE cuRREn Y/N <br /> Address '.._'M�—...—. License# �� � <br /> OTHER '_^� COMPANY <br /> SIGNATURE ,_,_ RECrsTE�o Y! N FEE CURRE� Y/N <br /> Address r^w License# � � <br /> RESIdENTIAL Attach(2j Piot Plans;(2}sets af Buitding Plans;(1}set of Energy Forms;R-O-W Permlt for new construation, <br /> Minlmum ten(10)wa�ictng days after submtttai date. Required onsite,CanstrucHon Ptans,Starmwater Plans wJ Sqt Fence instatled, <br /> Sanitary FaciliUes&1 dumpster,Site Work Permit for subdivislons4arge proJects <br /> COMMERC1At. ABach(3)camplete sefs af Building P{ans plus a Life Safeiy Page;(1)set of Energy Forms.R-O-W Permit for new construcUon. <br /> Minlmtsm ten(1Q}working days atter submittal date. Required ansite,CansWcUan Plans,8tormwater Pians w/Silt Fence ir►stalled, <br /> Sanitary FaciliUes&1 dumpster.Site Work Permit for all new proJects.All s:ammercial requirements must mee!compliance <br /> SIGN PERMiT Attach(2)sets of Engineered Plans. <br /> •'*"PRt7PERTY SURVEY requtred for at(PIEW conshuctlon. <br /> Directlons: <br /> � Fil1 out applicaHan campietely. <br /> Owner&Contraokor stgn back of app!lcatlan,notadzed <br /> If over S250q,a Notice of Commencement ts required. (AIC upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from ownerauthorizing same�' � <br /> DVER THE COUNTER PERMIT'17NG•, , :{Front of Application�Only) � ,, , - � <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurveylFoatage) , , <br /> Driveways-Not aver Counter if-an-public roadways::needs�ROW -� ' ° � "' ' ` "` � � ' <br />