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o,�-�a�-uUtu City of Zephyrhills Pecmit Application Fax 813-780-OU21 <br /> Buitding Qepartment <br /> Date Received J -- ��p� .,� pi�pne Contact for Permitting ~� - <br /> Owner's Name � Owner Phone t3umber ""? J� �� <br /> Owner's Address ��� �C !G. 7"vwner Phone Number <br /> Fes Slmpfe Tltlehaldsr Name � �� Owner Phane(dumber _,_,__ <br /> Fee Sfmple Tftledatder Address <br /> JOB ADbRESS l.OT# � <br /> SUBDiVIS10N �_ � PARCEL ID# <br /> (OBTAINED FROM PROPERTY TA?C NOTICE) <br /> WORK PROPQSEp e NEW CONSTR 8 ADdlAIT �J SIGN Q C] DEMOLfSN <br /> INSTA�I. REPAIR <br /> PROPOSED USE Q SFR Q COMM �� OTHER <br /> tYPE OF CONSTRUCTION Q BLQCK Q FRAME � STEEL Q <br /> DESCRIP710N OF WORK � � <br /> Bt3lLDiNG SIZE � � Sti FOOTAGE�� HEIGHT � <br /> QBUILDING � T_� VALUATION dF TOTAL CONSTRUCTIQN <br /> QELEC7RlCAL (;� � AMP SERVICE Q PROGRESS ERtERGY [� W.R.E.C. <br /> L ('�� ,� <br /> [�PLUMBING $ ��U �.. ,� �yM.i��iG�- <br /> � <,'u_. w�.,}, <br /> ��r <br /> QMECHANiCA� $ VALUATION 4F MECHANICAL lNSTALLATION �t t,� Wu� <br /> � <br /> _ �_ <br /> QGAS Q ROOFWG � SPECIALTY � OTHER y � <br /> =1NfSHED FL04R E1.EVATit?R!S �� FIOOD ZOIVE AF2EA QYES NO <br /> i� ���������.�.� <br /> 9UILDER r.�- � _ COMPANY �c�d'yL�t' �tr t ` ��e.C�C`}Y'.S <br /> 31GNATURE REGiSTERED Y! N FEE CURRE� Y/N <br /> Address �,, , �''t� License# C,.,_�C �7s'�r�'&�.. '� <br /> cLECTRICIAN COMPANY <br /> tIGMATURE REGTSTERED Y I N FEE CURRE� Y/N <br /> Addr�ss �yT� ' License# �yy_`�� <br /> �WMBER � COMRANY <br /> iIGNATURE RE�tSTEREO Y! N FEE CURREfi Y/N <br /> Address License# �i ' i� <br /> �ECHANiCAL. ` COMPANY <br /> iIGNATURE ,_,�_, RE6ISTERED Y I N FEE CURREM1 Y J N <br /> Address "_�— License# � y' � <br /> iTNER COMPANY <br /> �tGNATURE REGlSTEREQ Y! N FEE CURRER Y J N <br /> Address License# �� ' '� <br /> ;E5IDENTfAi. Aftacfi(2}Plat Ptans;(2}sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new constructlon, <br /> Minimum#en(18}working days after submittal date. Requtred onsfte,ConstruoGon Plans,5tormwater Plans w!Silt Fence instaited, <br /> Sanitary FaciliUes&1 dumpster;5lte Wark Permit for subdivisionsllarge proJects <br /> OMMERCIAL Attach(3)comp�eke sets of Building Plans plus a Life Safety Page;(1}set of Energy Forms.R-O-W Permit tot new construction. <br /> Mi�imum ten(10)working days'after submittal date. Required onslte,Construcflon Plar�s,Stormwater Pians wJ Siii Fence instafled, <br /> Sanifary Faciltties&1 dumpster.Site Work Pem►(t far all new proJacts.�411 commercia!reqvlremenES must meet comptiance . <br /> IGN PERMiT Attach(2)sets of Engineered Plans. <br /> "~"PROPERTY SURVEY required for all NEW constructlon. <br /> Irecttons: <br /> Fili out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over�2500,a Notics aE Gommenaement is required. {A/C upgrades aver yT500) <br /> Agent(for the contractor}or Fower of Attomey�(for the owner)would be someone with notarized letter ftom owner autharizing same <br /> VER THE COUNTER PERIV�lTTlNG (Front,of Applicatian Qnly} <br /> eroofs if shingles Sewers Servlce Upgrades AtC Fences(Plot/Survey/Footage} <br /> Drlveways-Not over C+ounter If on public roadways..needs ROW <br />