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s�s-�saooao City af Zephyrhills Permit Application Fax 813-780-OQ21 <br /> 6uildir►g Department _ <br /> qate Recelved . '�-.�,�.` .'" . -'"' i <br /> . �.�': Phone Con#act for Permitt3n � — <br /> �, - / /� - 1 i � -� �•- <br /> __,c_pwner's Name..� ,�� ! '�l� �/�� Owner Pho»e'Number, , � ` . <br /> 1Z� ��. Q �, � , , <br /> �Owner's Address � v j� � ��/ � � � , _Owher Phone,Number--�• �� � - - <br /> Fee Simple Tltleholder Name � Owner Phane Number � � <br /> i <br /> I <br /> Fee Simple Titieholder Address �', <br /> ��'JOB AbDRE58� �(,J�JI �/� � LOT# �_� <br /> .� <br /> SUBD1ViSiON �� � PARCEL ID# � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSftt ADDtA�T Q 51GN Q Q DEMOUSH <br /> e INSTALL. 8 REPAIR <br /> PRQPOSfiD USE Q SFt2 Q CQN1M Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK [� FRAME C] STEEL [� <br /> DESCRIPTION OF WOR!(� I I �Pt/ i..U ,� //1I �(C-'�IC�4/ �/I^� J'�^f� � �Ce Of�S � /%C�l� <br /> BUILDING SIZE SQ FOOTAGE[� 'I HEIGHT �� <br /> �g���d���' �` �� VALUATIOiV QF TOTAL CONSTRUCTIOh1 <br /> QE�ECTRICA� �J��11����rlo � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> U U <br /> [�PLUMSING $ � <br /> � � ! <br /> [�MECNANiGAL � � VALUATION QF NIECNANICAL I�tSTA��AT10N � '���J <br /> il <br /> QGAS Q 120QFlNG Q SPEGIAi.TY � OTHER <br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZQNE AREA QYES NO <br /> � � <br /> I <br /> BUILDER COMPANYi <br /> SIGNA7URE REGISTERED I Y/ N FEE CURRE� Y/N <br /> i <br /> i <br /> Addres� � License# � II <br /> ELECTRtC{AN� ��==/�''C�',���'/� COMPANY� �OC(Jt�� <br /> SIGNATURE `�..,_ REGI87ERED; Y/ N FEE CURRE� Y/N <br /> Address � License# �� � <br /> PCtlNtBER � COMPANY� <br /> 31GNATURE REGIBTERED Y/ N FEE CURRE� Y/N <br /> Address � License# � f <br /> MECNRNICAL CQMPANY� <br /> SIGNATURE REGISTERED i Y/ N FEE CURRE� „ Y/N <br /> Address � License# � '� �.1 I <br /> � <br /> OTHER COMPAElY; <br /> SIGNATURE REGISTERED� Y/ N . FEE CURRE� Y/N <br /> Address � l.icense# �� � <br /> RESIDENTIAL At#ach(2}Plat Plans;(2}sets of�BulidfngPlans;{1)set of Energy'Forms;R-O-W Permit for new cans#ruc6on, <br /> Minlmum.ten(40j.working;days;aftec submittal date. Required onsite,ConstrucNan Plans;Stormwater Pians w!S8t Fence instalied, <br /> Sanitary Faciltdes,8�1.dumpster,Site Work Rermit for subdivislonsAarge proJects <br /> CQNtME12C1A1. Attach{3}complete sets o#Saild9rig Plans plus al.[fe Safaty Page;{1}set of E�ergy Fanns,R-O-W Petmlt for new construcBon. <br /> Minimum ten(1�)working days after submlttal date. Required onsite,CansUuctian Plans,Stormwater Pians wi Silt Fence installed, <br /> Sanitary Facilides&1 dumpster.Site Work Permit for all new projscts.All commercial requirements must maet compliance <br /> SIGN FERMFT Attach{2)sets of Englneered P1ans._ - <br /> •""PROPERTY SURVEY required for all NEW constructlan. � <br /> - � <br /> Dlrectlons: � <br /> Fill out applicatlon completely. <br /> Qwner 8 Contraotvr slgn back of applicatton,natadzed j <br /> If av8r�25d0,a Natiae of Commencement i�requ[red. (AIC upgrades over�7500) <br /> '" Agent(for the contractor)or Pow►er of Attomey(for the awner)wauld be someone with notarized letter ftam owner authorizing same <br /> OVER'i'HE COtlNTER PEl2MITTING {Front of Apptication 4nly) <br /> Reroafs if shingles Sewers Service Upgrades A/G Fences(PIoUSurveylFootage) <br /> brivaways-Rlot over Cou�ter If an publlc roadways..needs R4W <br />