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' 8?3-780-Od20 City of Zephyrhills Permit Appiication Fax-813-780-0421 <br /> Buiiding Department <br /> Date Received � Phone Cantact for Permitting t5�� /r3� -- ��f� <br /> OwmeP's i�ame �t7"tt'RL�t�! � - ��� � Ovuner Phone Number �1 � ���'" %�� <br /> Owner's Address �%�� l�� �� ��� Ovvner Phone Nurnber � � �� <br /> Fee Simple Titleholder Name �� � � Owne�Phone Number � � <br /> Fee Simple Titleholder Address <br /> JQB�11D�RESS �!�,J �/~I � �j �� � ,��/1 L-L� ���e�- LOT# ��� <br /> SllBDi�dIStON ' �� �!!—� PAttCE�tD# f d�� �! Q7��G� L�� Qd t��` � <br /> (OBTAINEp FROM PROPERTY TAX N4TICE) <br /> WOftK PROPQSED ,e NEW CONSTR� ADD/ALT � SIGN [� Q DEMOLISH <br /> INSTALL REPAtR <br /> PROPOSED U�E Q SFR [� COMM C� OTHER - <br /> TYPE OF COMSTRUCTIOId Q BLOCK Q FRAME [� STEEL Q - <br /> DESCRtP710N OF IIVORK L'J � ,�i T �,i �31V I � d/U�� <br /> BUtL[IiNta 51ZE � �� Std FOOTAGE N�IGHT <br /> [�BUILDING �—� VALUATIQN OF TOTAL CONSTRUCTi4N <br /> QELECTRICAL � � AMP SERVICE [� PROGRESS ENERGY Q W.R.E.C. <br /> [�PLUMBING �� � - <br /> �MECHANICAL $ � �j pj� � VALUATION OF MECHANICAI.INSTALLATIQN <br /> f 1 <br /> �GAS Q ROOFING Q SPECtALTY � OTHER <br /> FINlSHED FL.00R ELEVATION5 (�� FLOOD ZONE AREA �]YES NO <br /> �. <br /> Bll1l.DER � COMPANY <br /> SIGMATURE REGISTERED Y I N FEE CURRE� Y/N <br /> A►ddress �icense# �+ � �� <br /> �LEG'TRICIAM � � COMPANY � <br /> SIGI�ATURE I REGISTERED Y/ N FEE CURRE� Y I N <br /> Address License# �— � <br /> P�.k9MBER � � �OMPANY <br /> SIGNATURE RHGISTERED Y/ N FEE CURRE� Y/N <br /> A►ddress E.�cense# � � <br /> fVIECHANiCAl. /�'��,. ` COMPANY �/� �5 �' „�����-�/U�., ' <br /> SIGIVATU6tE �"''��� ��� REGISTERED Y/ N FEE CURRE� Y!N . <br /> Address `''���/ �1 ��' �'scense# ��'b�v�'�J�� �� <br /> OTHER COMPAMY <br /> SlGfda4TURE REGISTERED Y J N FEE CURRE� Y/M . <br /> Address �icense# �— � <br /> RESID�lVTIAL Attach.(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit fo�new construction, <br /> Minimum ten(10)working days after submitfai date.`Required onsite,Constrvcfion Plans,Starmwater Plans w1 Silt Fence instailed, <br /> Sanitary Faciilties&1 dumpster,Site Worlc Petmit for subd9visians/large projects <br /> COMMERClAL Attach{3)corriplete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.Ft-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Cansttuction Plans;Stormwater Pians w!Sitt Fence insta[1ed, <br /> Sanifary Facilities&9 dumpster.Site Wark Permit for atl new prajects.Ali commerciai reguirements must meet campliance <br /> SItaN PERMIT Attach(2}sets at Engineered Pfans. <br /> «"""pROPERTY SURVEY required for all NEW construction. - . <br /> Directlons: <br /> Fill aut application completely. <br /> Owner&Contractar sign back of applicatian,notarized <br /> if aver a2544,a Notice of Commencement Is required. (A!C vpgrades over�7504j <br /> °* Agent(for the contractor)or Powsr of'Attqmey{for the ovmer)�wbuld be someane with notarized letter from owner authorizing same <br /> 01l�R THE COUNTfR PERMlTfING...;:..,�,=_(Frorit.of,Appiicatian.Oniy)....>.-; , � <br /> Reraofs ff shingles Sewers 4 Service.lJpgrades.AlC :Fences{ploUSurvey/Footage) <br /> � `.;..,;, : ., ,� ; : ; :` :, , <br /> �riveways-Not over Counter.;if on pubiic roadways:.needs ROIN � .` <br /> . . _. . ; <br />