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s��-7ao-oo2a City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Butlding Qepattment <br /> Date Recetved —� � Phone Cootact far Pe�ntttln — <br /> � <br /> Ctwrser's Name fJl�+�- Owner Phone Nu ber ���~�� � <br /> Owner's Address J �Q�� GJ L �G t le �� Owner Phone Nu <br /> .Feer3lmple Tltleholder.Name � Owner Phone Number � I <br /> F�e_Sinrple Titleholder Address <br /> !�JOB ADDRESS d��� �� � �f � LOT# �� I <br /> SUBDIVISION �� � PARCEL ID# I <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORiC PROPOSED y NEW CONSTR ADD/AlT � SIGN Q Q DEMOLISH , <br /> e INSTALL � REPAIR _ <br /> PRQPOSED USE � SFR � CO{VIM [� LITHER <br /> TYPE OF CON3TRUCTION Q BI.00K ° Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK � � �v <br /> BUILDING S1ZE � � SQ FOOTAGE�� MEIGHT �� <br />' �C������i��' � `� G'fQ��'""" VALUATION OF TOTAI CONSTRUCTION <br /> �•QELEGTRiCA� �� AMP SERt/ICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �P�UMg►�!G �_� .�l`Y��� � <br /> Q MECHANfCAI $ '� VA�UATION OF MECHANICAL INSTA�IATIQN � � �r�` <br /> GAS Rt?OFING , SPECIALTY OTFiEFt � �W����4 �� <br /> 0 o a o � <br /> FINISH�D FLOOR ELEVATIONS �� FLOOD ZQNE AREA [�YES NO �/��,/ <br /> L..' <br /> BtJ1�DElt i r���` COMPANY <br /> NATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> � ._. _ <br /> �I Address License# _ � <br /> � .�LECTRICFAN �` COMPANY ��'c2� <br /> SIGNATURE Y REGIS7ERED Y/ N FEE CURRE� Y/N <br /> Address License# �� � <br /> ; ��tlMBEl2 COMpANY �''���� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> , Address License# � � <br /> MECNAP!}GAt, COMPAR+lY <br /> SIGNA7URE REGIS7ERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> OfiHER COMPANY <br /> �i SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N i <br /> � Address - License# �� � � <br /> RESlD�NTIAL: Attach{2)Plot Rlans;_{2}sets af Bulldtog'Plans;(1}set af Energy Forms;R-O-W Permit fior new canstrucHon, <br /> Minimum ten(1.0)working days after submittal date. Required onstfe,ConstrucUon Plans;Stormwater Plans w/Silt Fence instalied, <br /> Sanitary Facilities&1 dumpster,Site Work•Rertnit for subdivisionsAarge proJects <br /> CONIMERCIl�t. Attach{3}complete sefs of_Builditig Flar�s.plas.a�tfe Safety Pags;(i}��t o#�nsrgy Forms.R-0 W Petmit for new construction. <br /> MiNmum ten(10)working days after submittal date. Requlred onsite,Construcdan Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Faailides&1 dumpster.Site Work_Permit for all'new proJects.All commercial requlrements must meet aomptlance <br /> StGN PERMIT Attach{2)sets af Engineered Plans. �� � . . <br /> ""PROPERTY SURVEY required for,all NEW,canstructian. � ' - ' " <br /> Dlrections: ° _ � <br /> FIII out applicatlan completely. <br /> Owner&ContracMr sign back of applica8on,notadzed <br /> If ovsr 52500,a Nottce af Commencement is required, {A/C cipgrades ovar ST500} <br /> " Agent(for the contractor)or Power of Attomey(for.the.owner)wauld:be someone with notarized letter f�rti owner-authorizing same , , , <br /> ��i�•�;}:,� ij; " :;t� - <br /> t}VERTHE CCtUId7ER PERMITfiNG��,= .,- tFrontof�l°�APlicatiqn.Only}`;?" �' �: �. : , • � : ' ,� _ . <br /> Reroofs if shingles Sewers `.Service Up'grades;NC'� Fence§(PIoUSurvey/Faotage) '�; , . , ` . <br /> Drivewaya-Not aver Counter if on.public"roadways,.needs ROW-_=� ' '` ' + �- - rt =� -� -- i _ <br />