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a�s-�so-oo2o City af Zephyrhills Permit Application Fax-813-780-0021 <br /> . Buiiding department <br /> Data ttecefved.. I .. . �......>�.. _ ...<_�.,... .ri.. .� �, <br /> _ h e.Cantact k►r Perrtiiftlri" �,. —�r i <br /> Owner'sNaine - '� -�"�' :I�. . �' '.': ,_.,,,", . .`,:;•� ,,��,� - � I' <br /> :t'- =.Owiie�Phone Nembe�'=� <br /> .; ;.•�:; . '(' , „�:�' "'�'r; `.=. z�-_.:� ��;., _ ... ', <br /> Owner's Addresl � � ' ��Owner Phone Nomber� ,� � <br /> , � , : � s ,I� ��'.,. _ . . � <br /> - t � � � � <br /> Fee Simple"Titleholde'r Name ,' ,, � Owner Phone Number <br /> 1 � � <br /> � � ' I <br /> Fee Simple Titleholder Address I " <br /> JOB ADQRESS � � � �'�'� - LOT# �� <br /> , , <br /> SUBDIVISION � � " � ��;, PARCEL ID# � �� '��.- �'� ' o b 3 0 — D C 6 0 Q � 0 O�Ca <br /> '� � (OBTAINEQ FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR . ADDlAtT �` S1GN Q Q DEMOk.ISH <br /> , � �e INSTALL 8 REPAIR I <br /> PROPOSED USE Q SFR Q COMM �,� OTHEF2 <br /> TYPE QF CONSTRUCTION � BLOCK Q FRAME I STEEL Q <br /> DESCRIPTION OF WORK � � <br /> BUtLDtNG SiZE SQ FOOTAGE�_'�� HEIGHT �______� <br /> �$�t����� ���.�.�lBLUATION QF T i TAL CONSTRUCTION <br /> QE�ECTRICAl. ri� AMP S�RVICE Q PRQGRESS Et�2ERGY � W.R.E.C. <br /> L , <br /> QPLUMB��lfi,� $ , � t�'�L� � <br /> 1 � �������'�� <br /> MECHANICAL �~��/�'' - <br /> C] $ VAI.UATION C}F M i CHANICAI.INSi'ALLAi'fON �_� f��� �/ <br /> � .� <br /> ' QGAS Q ROQFING Q SPECiAl.TY ; OTHEE2 <br /> FINISHED FLOOR ELEVATIONS ��� FI.00D ZONE�AREA QYES NO <br /> BUI�DER COMP� <br /> , 51GNA7URE REGISTERED Y/ N FEE CURRE� Y/N <br /> ' Address License# � <br /> , E�ECTRiC1AH COMP� <br /> SIGNATURE REGI3TERED Y/ N FEE CURRE� Y/N <br /> Address License# �� �� <br /> PCUMBER CONIRANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> �� � t <br /> Address '� License# �i � I <br /> I ! <br /> MECHANICAI. COMPANY ' <br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N II <br /> I <br /> Address - I icense# <br /> � <br /> OTHER GOMPANY <br /> SIGNATURE REGISTE � Y/ N FEE CURRE� Y/N. <br /> Addre�s � License# �_ � <br /> � <br /> FtES1DENTIAL Aftach{2)Ptaf Plans;(2)sets o#�BuIlding"Plarts;{1}set af Ene�gy�Forms;R Q-W Pecmlt for new coostrttction, <br /> Minimum,ten_(10).working days after.submlttal date. Required onsite,,Construcdon P1ans;Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Faollides&1_dumpster,Sita Worlc;Rermit for subdivisionsAarge projects <br /> COMMERGIAL Attach{3}complete set�of Bu3ldtrig P1ans ptus a�ife Safe#y Page;(i)set of Energy Forms.R-4 W Pecmtt for new canstrucHan. <br /> Minimum ten(10)wo�lcing days after submittal date. Required onsite,Canstructian Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaoiliUes&1 dumpster.$ite Work Pertnit for all new proJects.All commercial requlrements must meet campliance <br /> SIGN PERMIT Attach{2)sets o#Engineered Plans. � i <br /> '•*"pROPERTY SURVEY required for ail NEW construcUon. 'f <br /> Dlrectlans: i" <br /> FUI out application completely. i <br /> Owner&Contractor slgn back of appllcarion,notarfzed i <br /> tf over 52500,a Notice of Cammenaement is required. {A/C upgrades dver 57500) <br /> '" Agent(for the contractor)or Power of Atkamey(for the owner)wauld be sameone with nota�zed letter fram owner autho�izing same <br /> DVER THE COUNTER PERMITt1NG (Front af Applicatton Onlyj <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Foatage) <br /> Driveways-Not over Counker if on public roadways..needs ROW � <br />