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- s�s-�8o-ooaa City af Zephyrhills Permit Application Fax 813-780-0021 <br /> 8utlding Deparbnent <br /> � , ---:_ <br /> Date Received � -�j --��� Phone-Contact far Retmlttin <br /> �,Owner's Name ����/¢ /(1 cy Owner Phane Number �f - ��� <br /> �Owner's Address � 1�/l��'C7v� ��„ Owner Phone Number �j�G.`��-4���"��'/ <br /> Fee 5lmple Titlebolder Name Owner Phone Number �� � <br /> Fee Simple Titleholder Address <br /> aJ08 ADDRESS ?ca�o�O /()bQ ,EP�� LOT# �� <br /> SUBtlIViS10N �— � PARCEi.tD# <br /> I (08TAINED FROM PROPERTY TAX NOTICE) <br /> WORiC PROPOSED NEW CQNSTR ADD/AtT � StGN Q Q DEMOI.ISH <br /> INSTALL REPAIR <br /> PROPOSED USE [� 5FR [� GOIUIM Q OTHER <br /> 7YPE OF CONSTRUGTiON Q BLOCK " Q FRAME � STEEL Q <br /> 7L DESCRtPTION OF WORK �r Cl�'"^a , /i� � �`� <br /> BUILDlNG Si2E ���v( � � SQ FOOTAGE�� NEIGHT ��� <br /> �'�$u������' •�" VALUATION OF TOTAL COiVSTRUCTION <br /> 1 � � �•�....:� <br /> DELECTRIGAI. r; � AN]P SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> L ,V <br /> QPLUMBtNG $ �`({�� � <br /> . �� ���--�✓��� <br /> MECHANtGAL $ � VALUATIQN OF MECHAPlICAL lNSTAL.l,4T10N �-' � <br /> � $� �. �a����`� <br /> QGAS Q E2QQFING Q SPEGIALTY 0 OTHEFt <br /> � � <br /> FINISHED FLOOR E4EVATIONS �-----� FLOOD ZQNE AREA QYES NO <br /> „�8!!lIDER ��)"' � � COMPANY � ��i� <br /> SfGNATURE ��-��� O��m��."� r REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r� �� <br /> ElEC7RICIAN COMPAPIY <br /> SIGNATURE r REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# � � <br /> PLUMBER � � COMRANI� <br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� Y/N <br /> Address License# �_ � <br /> MECHANIIGAL CflMAANY <br /> SIGNATURE REGISTEREU Y/ N FEE CURRE� Y/N <br /> Add�ess License# � � <br /> OTNER COMPANY . <br /> SIGNATURE _ REGISTERED Y/ N . FEE CURRE� Y/N , ' <br /> � <br /> _.__� Addro�s . License#_� � <br /> ________. <br /> �-----:.-- ___ <br /> RESii?ENTIAl. Attach(2)Plot P#ans;(2�sets of Bu3lding Plans;{1)set af Energy�Forms;R-O-W Permit for new canstruatian, <br /> Minimum:ten(10}.working daysafter submittal date. Required'onsite,Constructlon Pians;Stormwater Plans w/Silt Fence instailed, <br /> San(tary Facilities&1 dumpster,Site Woric;Pertnit for subdlvisionsAarge projechs <br /> COMMERCIAl. Attach{3}campiete seis of Su3ldirig Pians plus a l.tfe Safety Page;{1)set of Energy Forms.R-O W Permit far new canstrucUon, <br /> Minimum ten(10)working days after submittal date. Requlred�nsite,Constructian Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitfes&1 dumpster.Slte Work Pertritt for all new p Jects.Ali commerclal requirements must meet compllance � <br /> StGN PERMiT Attach{2)sets af Eiiglneered Plans. � <br /> "'"PROPERTY SURVEY required for all NEW canstruction. <br /> Dlree#lons: <br /> Fill out applicadon wmpletely. <br /> Owner&Contractor sign back of apQUcatlon,notarized <br /> if ovar a2500,a Noflce of Cammencemen#ts required. {A/C upgradss o ler�T500) _.� , _ <br /> ._�,�•: <br /> '• Agent(for the cantractor)or Power•of�Attamey(for the•owner:).wouid.be,someane with notarized letter from ownec authorizing same � . . <br /> DVERTHECOUNTERPERMITTING� -(Froiit�ofAppllca#ion,.Only)',..;��° . . , , , , , <br /> Reroofs if shingles Sewers Service Upgrades.,ALG� ' Fences(Plot/Survey/Footage) , , � - - <br /> priveways-Not over Gaunter tf on�perb{Io�roadways:.needs,ROW,,.�.;;;`.w,.�r ! .. .~ . .> � ••<.�..> . -, . , <br />