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s�s-�eo-oo�o City of Zephyrhills Permit Application Fax 813-780-0021 <br /> � - Butlding Departrnent <br /> : i . <br /> Date Reaeixed Phane-Contact for Pe i ittin <br /> Owner's Nama � i�-1��-- Owner Phone Nomber <br /> Owner's Address �"J c.+ �� Owaer Phone Number �� � ` <br /> Fee Slmple 7ltleholder Nami�1�'� � Owner Phone Number �� � <br /> i <br /> Fee Stmple Tltleholder Address � <br /> JOB ADDRESS LOT# <br /> �� <br /> Si1BdiViSiON �` � PARCEL tD# ' <br /> I (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CBNSTR ADD/A�.T C� SIGN Q Q BEMOLISH <br /> INSTALL REPAIR I <br /> PROPQSED USE Q SFR Q COMM ' �,� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK R Q FRAME C� STEEI. Q <br /> DESCRIPTION OF WORK �� �l`- �� t{ ��`G!C ��L.J <br /> Q F <br /> BUII.DING StZE ���� Sq FOCiTAGE HEIGHT C� � <br /> i <br /> �8��`����"" r� VALUATiON OF TO7Al CONSTRUCTION <br /> , L�, � <br /> �ELECTRICA� �� AMP SERVICE Q PFiOGRESS ENERGY Q W.R.E.C. <br /> OF'�UMBtNG �....� ( �.,„,.--� <br /> 1� s <br /> QtV1ECttANtCA� $ �.Q � VAi.UATIQN OF MECHANIGA�INS7RLG4TlOM ��� <br /> QGAS Q t200FiNG [� SFECIAI.TY �� OTHER �� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> I � <br /> BUI�OER COMP a <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> i <br /> � <br /> Address � License# � <br /> � � �(c � �c-�.� <br /> ELECTRtC1AN COMP� f✓ <br /> SIGNATURE � �/ REGISTERED Y/ N FEE CURREt� Y/N <br /> i <br /> Address � I � License# ��'dC3��Q � <br /> � � <br /> P�UiU1BER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> i <br /> Address � License# 1 -� <br /> MECHANICAL ._� C�MPAFlY !�JSn C.4w`1 r <br /> SIGNATURE REGISTERED Y/ IV FEE CURRE� Y/N <br /> I <br /> 1 / <br /> Address ' I License# L �� � <br /> OTNER COIUlPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N. <br /> Address License# � � <br /> RE$lDENTIAL Attactf{2)Ptof P#ans;(2}ssts af.Bullding'Plans;{1}se#of En'ergy�Forms;R-O-W Permit for new constru�ction, <br /> Minimum ten.(1Q)working days after submlttal date. Required onsite,Gonstrucdon Plans,Starmwater Plans w/Silt Fence installed, <br /> Sanifary Facilitles&1.dumpster,Site Wortc•Rermit for subdivisiqns/large projects <br /> C4MMERCIAE. Attach{3}complete sets of BuilcSirig Plans p4us a Life Safety Page;{1}set of Energy Fnrms.R-U-W Permit for new constructlon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construation Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Worlc Permi4 for all new projects.All commercial re4utrements must meet compltanca ' <br /> 51GN PERMIT Attach{2)sets of Englneered Plans. � • <br /> ""*"PROPERTY SURVEY required for all NEW construaUon! <br /> Diceatlans: <br /> Fill out applicatlan completely. � <br /> Ow�er&ConVactor sign back of appitcatlon,notarized � <br /> if over$2500,a Natice of Commencement is required;M(ktC.upgradesi over ST500) <br /> < . ,,,,,.-,.u�..:-�. <br /> '• Agent(for the co�tractor)or Rower of Attomey-(for_the owner.)'woulii.be someone with notarized letter from owner authorizing same <br /> 4VERTHE COUi�TER PERMI'i'TING �• .i'{Fiant.ofAppllcation-Only)" T<�{ � <br /> Reroafs if shingles Sewers � Service UpgredesNA/CY FFences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on putilic roadways..needs ROW � <br /> , <br /> I <br /> � <br />