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���-,o�-���u City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Buitding Department <br /> .�';4 _ <br /> Ltate Rscefved �-/��'/,� Phone Gontact for Permitting �g� ��3 - ���� <br /> Qwner's Name Q/���j� Owner Phcne Number ��',� '° ���F �� <br /> Owner's Address c7 d �� �j�'� �'�� Owner Phone Numbsr <br /> Fee Stmqle Titleholder Name � � O+e►»er Phone Number �� <br /> Fee Simpfe Titlehalder Address <br /> JOB ADDRESS � � � �� L�� 1.07# .�� <br /> suaomsroN [J cr�v,��.�'������ PARCEL ID# Q�-�� `° �0 -�9 C'� --� — � t� <br /> (OBTAINED FROM PROPERTY TAX NOTICE! <br /> WORK PROPOSED e NEW CONSTR 8 AOD/A�T � SIGN [� [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM �] OTHER <br /> TYPE OF CONSTRUCTION Q BIQCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK l'L'G.s� � �j ��� '- � S�p '� `"� ��s � <br /> BUIldiNG SIZE �� � SQ FOOTAGE a6 � HEIGHT ��_� <br /> �BUILDING � ����� VAI�UATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ � AMP SERVICE Q PRCIGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> �._,� /� <br /> QMECHANICAI (9i��� VALUATION OF MECHANICAL INSTALLATION �`C� 1 <br /> L. ,�\ <br /> QGAS � ROOFWG Q SPECIAI.TY � OTHER <br /> FlNISHED FLOOR E�EVRTIQNS �� FLOOD ZONE AREA QYES NO <br /> BUILDER CQMPANY <br /> S{GNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address License# � �Ti�� <br /> ELECTRICIAN COMP�11etY <br /> SIGNATURE REGISTEFtED Y/ N FEE CURRE� Y/N <br /> Add�sss Llcense# �` i � <br /> PLUMBER ` � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREh Y/N <br /> Address License# �` i� ] <br /> MECHANiGAL COMPANY <br /> SIGNATURE REGISFERED Y i N FEE CURREh Y t N <br /> Addrgss License# r�i �'� <br /> a�ER � ���� co�nParnr �i�l.����reJ e�DdFirs,/� Bee�� <br /> 5(GPIATiiRE ' REGISTERED Y/ N FEE GURREA Y/�V <br /> Address 7j � �����f� Ar�l ,R"` � .� �'j License# ��� ����� � <br /> RESiDENTi1�t. Attacfi(2}Qlot Ptans;(2}sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new canstruction, <br /> Minimum ten(10)working days after submittal date. Required onslte,.Canstructton Plans,Stom►water Plans w!Sltt Fence(nstatled, _ _ _ _ <br /> Sanitary FacliiBes&1 dumpster,Site Work Permit for subdivisionsAarge proJects <br /> GOMMERCtAL Attach(3)comptete sets of Buliding Plans plus a Lffe Safeky Page;(1)set of Energy Forms.R-O-W Permit for new construet3on. _ __ -_- -_ -- <br /> Minimum ten(10}working days'after submittal,date. Required.onstte,-Conshuction Plans,-Stormwater Plans w/Silt Fence.ins#alted, <br /> - - - Sanitary Facflities-&1`dumpster.Slte Vllork Permit far aU new proJects.A!!commerclal requlrements musYmeet compflance <br /> 51GN PERMIT Attach(2)sets of Enginee�ed Plans. • <br /> """PROPERTY SURVEY required for all NEW constructton. <br /> Directions: <br /> Fill out appiicaHon completely. ' 1 <br /> Owner 8 Contractor s(gn back of appifcatlon,notarized • �� �. ' <br /> If over 52540.a Notice af Commgnaement Is requlred. (A!C upgrad�s�ove�,,ST500} --�- . � '� 1'� � �, <br /> '* Agent(far the cantractor}ar Pawer of At#omey(for the owner}would be'someone with notarized letter from owner authorizing same " � <br /> DVER THE COUNTER PERMITTING {Front of Appfication Only} _ , , „ „_ . , v_ , . <br /> Reroofs if shingles Sewers Senrice Upgrades AtG Fertces(i'IotiSurveytFootage} , , ,- , � <br /> Driveways-Not over Counter if on publfc raadways.,needs ROW, -- . ' , � '� 1 ' 1 <br /> ., � i •°--.. .. .., .�.� .,. � ._ '...:" ,. <br />