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813-780-002p City of Zephyrhills Permit Application Fax-813-780.0021 <br /> Building Degarhnent - <br /> .-- Date'`�tecetved Phone Ccntact far Permittie – <br /> I <br /> Owner's Name � � Qwner Phone Numbar <br /> Owner's Address Owner Phone Number �� � <br /> Fee Simple Titleholder Name � � Owne�Phone Number � � <br />� <br />(, ( <br /> II <br /> Fee Simple Titleholder Address I <br />� JOB ADpRES3 �...J � � ��h U`Q.� LOT# C__i� <br /> SUSDIVISION � —� PARCEL ID# <br /> � (QBTAINED FROM PROPERTY TAX Np710E) <br /> WORK PROPOSEd NEW CON5TR ADD/ALT � SIGN Q Q DEMOtt$H <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE dF CONSTRUCTION [� BLOCK " Q FRAME � STEEL Q <br /> DESCRIPTION OF WQRK I�C� -C�(' (�6' `-J(�� 'C/ � <br /> BUILDtNG SIZE SQ FOOTAGE�_� HEiGHT C�� <br /> ��������� �� VALUATiON OF TOTAL CONSTRUCTION <br /> �ELECTFtICAI. �p�� U� � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLt1MBlNG �> � <br /> QMECHANiCAI $ VACUATION OF MECHANICA{.INSTA�LATI{)N <br /> ��� ��� <br /> [�GAS Q ROOFING Q SPEGIALTY C� tJTHER <br /> � <br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA QYES NO <br /> BUI�DER COMpANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N. <br /> Address License# �� � <br /> ElECTRtC1AN f-� GBMFANY � � �- GUL..1 <br /> SIGNATURE ' -���`'' REGISTERED Y/ N FEE CURRE� / <br /> I Address � License# �— � <br /> PIUMBER COMR� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �� � <br /> MEGMANIGAL COMPAt+�Y <br /> SIGNATURE REGIS7ERED Y/ N . FEE CURRE� Y/N <br /> � Address I License# r I <br /> ! OTMER COMPAF�Y <br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre� License# �— � <br /> � <br /> t2ESiDENi7At. Attach{2�Plat Pians;{2)se#s of Btiilding°Plans;(1}se#of Energy�Forms;R-Q-W Permit for new construcBan, <br /> Minlmum ten(10)working;days aftec.subrriittal date, RequlrecJ onsite,Construcdon Plans;Stortnwater Pians w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster Site Work=Permft#or subdivisionsflarge pmJects <br /> C4MMERCiAL Attach{3)complete sets of Buildirig Plans ptus a Ufe Safe#y Page;(1)set of Energy Farms.R-O-W Permit for new cxinstruction. <br /> � Minimum ten(10)working.days after submittal dat�: Required onsite,ConsUucUon Plans,Stormwater Plans w/Sflt Fence installed, <br /> � ° � Sanitary Facilities 81 dumpster.Site Work Permit for all new proJects.All commereia!requirements must mest compllance <br /> SIGN PERMIT Attach{2}se#s af Englneered Plans.. <br /> •••`PROPERTY SURVEY required for all NEW construcUan. <br /> Dtreetions: <br /> Fill out appltcadon completely. <br /> Owner&Contraclor sign back of applicatton,not,aeized <br /> tf over$2500,a Notice af Commencement is requi�ed, (A/C upgrades over$T500) <br /> `" Agent(for the contractor)or Power of Attomey(for the owner)wauld be someone with notarized letter fram owner authorizing same <br /> DVER THE CdUNTER PERMI'i'TiHG {Front of App{ication Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not aver Counte�if on pubtic roadways..�eed's ROW � <br />