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813-780-0020 City af Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> , . <br /> � <br /> Qats Recelved Phane-Caetact far Permltt�n – <br /> .."�' P / <br /> 4wner's Name �Cll �v�/'� Qwner Phone Namber � l�C� <br /> Owner's Address Owner Phone Number �j� v�Gx "(:�'�!,�I <br /> Fee Simple Titleholder Name �, � Owner Phone Number �� � <br /> Fee Simple Titieholder Address <br /> JOB ADDRESS � Uv�'�GLd"�;9 �.., LOT# C� <br /> SUBDIVISION '�-j!l��sC" L/r'�� PAFtCEL tD# <br /> (OBTAINED FROM pROPERTY TAX NQTICE) <br /> WORK PROPOSED � e NEW CONSTR 8 ADDIALT Q SIGh! Q [� DEMO�ISH <br /> INSTALL REPAIR <br /> PROAOSED LiSE Q � SFR Q COMM C� OTHER <br /> TYPE dF CONSTRUCTION Q BLOCK " Q FRAME C� STEEL Q <br />' DESCRIpTION OF WQRK vI�'/d�l�",� ��' `�`�`�� <br /> BUILDti�G StZE � � SQ POOTAGE ��L� HEiGHT ��f � <br /> i ���iL�»� �_� ,VALUA710N QF TOTAL CONSTRUCTtON <br />� <br />� QE�ECTFtICAL � � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMSlNG � � <br /> QMECNANtCA� (;6��/��� ��, VAlUAT10N dF MECNANIGAI.INSFALLATION ��� J <br /> � � / j <br /> QGAS Q RQQFING Q SPEClR1.TY [� OTHER <br /> FINISHED FLOOR ELEVATIONS ��� F1.00D ZONE AF2EA QYES NO <br /> BUt�DER COMPAt�lf <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �� � <br /> ELECTRICIAN COMPAl+lY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � Llcense# �� � <br /> P�UMBER COMpANY <br /> .f''�"'iIGNATl1RE REGISTEREO Y/ N FEE CURRE� Y/N <br /> ' Address License# � � <br /> i <br /> � <br /> MECHANfCAL ��.r CflMPAf�tY �-!�� � .�% - �' � <br /> SIGNATURE /� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— � <br /> IOTFIER COMPANY <br /> �, SIGNATURE REGISTERED Y/ N. �E cu��n Y/N <br /> , Address License# �_ � <br /> � E2ESIDENTIAl. Attach(2}P!o#Plans;{2)se#s�o€Butlding Plans;(1}set af Eriergy�Forms;R f3�W Permlt for new constnsc#ion, <br /> Minimum.ten(10)working days after.submittal date. Requlred onsite,Construction Plans;Stortnwater Plans w/Sllt Fence installed, <br /> Sanita'ry Facilides&1;dumpster,Site Work�Rermit for subdivis(onsAarge proJects <br /> COMME1tCiAi. Attach�3)complete sefs af Buildirig Plans plus a l.ife Safe#y Page;{1}set of Energy Fortns.R-O W Penn{t for new cons�uc8on. <br /> Minimum ten{10)working days�after submfttal date. Required onsite,Canstructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FacUiUes&1 dumpste�.$ite Work Permit for all new proJects.All commercia!requirements must meet compilance <br /> StGN PERMIT AttacFi{2)sets cif Erigineered�Plans. ,. � <br /> ""PROPERTY SURVEY required for all NEW construcdan. <br /> t}Irections: <br /> Fill aut applicadon completely. <br /> Owner&Conlractor sign back of applicaUon,notarized <br /> if over 52500,a Natice of Commencement ts requirad. {/VC apgrades over aT500) <br /> `* Agent(for the contractor)or Power of Attomey(for the owner)wauld be someone with notarized letter from owner autharizing same <br /> � DVER THE COUNTER.PEftMITTiNG (Frant of Application Only} <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> {�riveways-tVot aver Coun#er if on public roadways..needs ROW <br />