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I <br />' a�s-�ao-ooao City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Butlding Department - <br /> Date Rec�ived P Gonkact for P��ttltting�, .� ����,.�� ��.����� .�. <br /> I . t' � : ,. ��:, :� ; �: ' , <br /> I' ,: � <br /> Qwner'a Name '� �O"vreer Phone Nusrilie'r_ r <br /> n � <br /> -.;�.n,,;.....,�...,..•..�.�.,. .. .. ' " ``: � <br /> IOwner's Address �� y�� � Owner Phone Number . ; <br /> i i <br />� Fee Slmple Titleholder Name Owner Phone Number ' <br /> 9R, , <br /> � � <br /> Fee Simple Titleholde'r Address � � <br /> JOB AqQRESS I LOT# ��� <br /> � <br /> 3UBDiVISION � � PARCEL ID# � � ` <br /> . • � � - (OBTAINED FROM PROPERTY TAX NQTICE) <br /> i <br /> WORK PROPOSED {VEW tONSTR ADD/ALT �]� SIGRt Q Q DEMOLiSH <br /> � e INSTALL 8 REPAIR <br /> PRflPC1SED i1SE Q ,, 8FR Q COMM �] qTFtER <br /> TYPE OF CONBTRUCTION Q � BLOCK Q FRAME STEEL Q <br /> pE3CRIPTION OF WORK l/► ,l <br /> � <br /> BUILDING SIZE �i � SQ FOOTAGE HEIGHT �_____� <br /> 0����'�i��' ���� VALUATION QF TOTAL CONSTRUCTION <br /> QELECTRtCAI. �> � AMP SERVICE ; Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBENG $ � <br /> OMECHANlCAL �� VAIUATtON OF MECHAIdICA�INSTAL�ATION <br /> � O�`� O ROOFING Q SPE£!Al.TY � OTHEFt <br /> FINISHED FLOOR ELEVATIONS �� FI.00D ZQNE AREA QYES NO <br /> � <br /> I <br /> � BUILD�R COMpAi�1Y <br /> SIGNATURE REGIS7ERED Y/ N FEE CURREA Y/N <br /> � <br /> 'i Address License# �— � <br /> I �IECTRtC1AN COMPANY <br /> , SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres$ License# �— � <br /> ! <br /> PLUMBER � COMPAR�IY <br /> , SIGNATURE REGISTERED Y/ N FEE CUFiRE� Y/N <br /> Address License# �! � <br /> I `_' i <br /> i MECHANICAI. CflMPAt�tY <br /> ' SIGNATURE REGISTERED Y/ N FEE CURRED Y/N <br /> I <br /> Address nse# <br /> � <br /> � tiTHER COMPANY <br /> �i SfGNATU REGISTERED FEE CURRE� Y/ . <br /> Address Llcense# �_ T� <br /> RESlDENTIAi: Attach(2)t?!ot Plans;{2}sets af Bullding'Pians;{1}set of Erie'rgy�Forms;R-0=W Pennit#ar new construction, <br /> Minimum,,ten(10)working days after.submittal date. Requiretl onsite,ConstrucBan Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1.,dumpster Site Work�Pertnit for subdiVisionsAarge proJects <br /> COIVIMERCtAL Attach{3}complete s�ts of Buildirig'Pians p[us a�ife Safet}r Page;{1)set of Energy Farms.R O-W Permit for new canstruction. <br /> Minimum ten(10)working days affer submittal date.. Required onsite,Constructian Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilides&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet complfance <br /> 81GN PERMlT Attach{2)sets af Engineered Plans. ' <br /> "'"PROPERTY SURVEY required for all NEW construction. ' <br /> Direstlons: � <br /> Ffll out applicatlon completely. � <br /> Owner&Gontracior stgn back of applEcatton,notarized <br /> 1f over 52500,a Notice of Commencemer+t is rsquired. (AtC upgrades over 57500) <br /> '• Agent(for ttie contractor)or Power of Attomey(for the owner)would be someone with natarized letter from owner authorizing same <br /> DVER THE Ci�ItNTER PERMITl1NG {Front af Appticatlon Only) � <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Foatage) <br /> Driveways-Not over Counter if an publlc roadways..naeds ROW i <br /> ! <br />