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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ' Buiiding Department <br /> � _ . , r.. <i....c ..ai .i..-.4•..f--. •-• �ii . <br /> Date RecAlved , . .�. r.:,.: - �r � .._HI,-,.:�. w..,,.,.K r. ...�..,..•.., • .... ... 3 <br /> .,,�,..'.�,,. »,,,• PhaneCaetactforPermittiYi... , �: <br /> m <br /> Owner's Name "°� � Gl. ' ��--Z`J � ;Owner Phone�N4m_b,er 7�7' �1 Z� <br /> i } � L _ _._�r.,,�_.-..,. _,�-_:,. � - <br /> Owner's Address ��[ C_3T � �z�Owner Phone Number �!3 .���a-,�7�J I <br /> Fee Slmple Titleholder Name � � Clwner Rhone Number �— � <br /> Fee Simple Titleholder Addres� <br /> JQB AddRESS � — LOT# �� <br /> � <br /> SUBdIVIStON � � PARCEL tD# <br /> I (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PRt}POSED NEW CONSTR ADDIA�T Q SEGN Q Q DEMO�ISH <br /> INSTALL 8 REPAIR <br /> I PROPOSEQ USE [� SFR Q COMM � OTNER <br /> 1YPE OF CONSTRUCTIbN � Q BLOCK Q FRAME � S7EEL Q <br />' DE3CRIP't10N OF WOR1C - Y�C '" �t..}b OC'.�.e,�l, � — � ��. <br /> BllIl.D1NG SIZE ��`� Sq Ft}OTAGE HEIGHT ��� <br /> � <br /> 08UILQING $ , ��']��''jo� � <br /> C--���=.�="'� VA�UATION OF TOi'A�CONSTRUCTIt�N <br /> QELECTRiGAL �>� AMP SEE2VICE Q PROGRESS ENERGY Q W.R.E.C. <br />� <br /> QPLUMBING $ �� �� r <br /> �,�v <br /> QMECHANICAI. $ VALUATION OF MEGHANICAL INSTALtATlOtV �� `�� <br /> QGAS [� ROOFING [� SPEClALTY Q OTHER <br /> Fi(VISHED FLOQR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUlIQER � COMPANY <br /> SiGNAT E REGISTERED Y/ N FEE CURRE� Y/N <br /> Addr s ttcense# � � � <br /> ELECTRICIAN COMPANY <br /> StGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Add�ass License# � � <br /> PLUMBER �� COMPANY <br /> StCaNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address ' LiCense# � �� <br /> MECHANICAL CQMPANY <br /> StCiNATURE REGISTERED Y J IV FEE CURRE� Y/N <br /> Addrass license# �— � <br /> OTHER COMPANY <br /> SIGNATURE a�c�srEr�o Y/ N ��cuR�n Y/N. <br /> Address Ucense# ( � <br /> RESIDEN'11AL Attach(2)Plat Plans;(2)sets of Building Plans;{1)set of Ene►gy Forms;R-O-W Perrtilt for new construcL'an, <br /> M3ntmum.ten(10)working:days after.submlttal da#e. Requlred onslta,Gonstruction Plans,S#ormwater Plans wt Silt Fence instalted, <br /> Sanitary Facilities&:1,dumpster,Site�WorlrPermit for subdtvislo�sAarge-projects <br /> COMMERGIAL Attach(3)complete sefs of Buildirig Plans plus a Ltfe 5afety'Page;(1}set af Energy Fcsms.R-O-W Permit for new construction. <br /> Minimum ten(1 Q)wotklag days after submittal date. Required ansite,Construction Pians,3tormwater Pians w/Sil#Fence installed, <br /> Sanitary FaciltUes&1 dumpster.Site Work Permtt far all newr proJects.All cnmmercial requirements must meet compllance <br /> SlGN PERMIT Attach(2)sets of Engineered Plans.. ( <br /> `*"PFtOPERTY SURVEY required for alt NEW cansUvction. i <br /> Dlreatlons: <br /> Fiil aut applicaBon c�inpletely. � <br /> Owner B.Contractor sign back of applfcaUon,notarized <br /> lf ovsr�2500,a Natic�of Commencement la required. (AtG upgrades over�7500} <br /> '" Agent(for the cantractor)or Aower af Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> �YER THE COUN'iER PBRMtTTiNG (Front of Appitcatlon Qniy} <br /> Reraafs if sfiingles Sewers Service Upgrades A/C Fences{Pio#JSurvey/Footagej <br /> Driveways-Not over Gounter if on publtc roadways..neads RQW <br />