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a�s-7eo-ooza City af Zephyrhills Permit Application Fax813-780-0021 <br /> r . , Building Department <br /> Date Received Phone-Ccntact for Permitttn — � / <br /> 4wner'�Name Owner Phone Number r,� � ' � � �6�� <br /> Owner's Address Q .rL��Yc� � . Owne�Phona Number � � � <br /> Fee Simple Tikleholder Mame � � Owner Phone Number � � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��/ ' LOT# L� <br /> SUBDtVIS10N �_---��,�� PARCEL tD# � G��O o`L C�I D C�C� 0 U <br /> (OBTAINED FROM PROPER7Y TAX NQTICE) <br /> WORK PROP{3S5D NEW tONSTR ADDtALT �� SlGN Q Q DEMflLISH <br /> � INSTALL e REPAIR <br /> PRQPQSEd USE Q SFR Q COMM � OTHER JSrJn) <br /> 1YPE QF CONSTRUCTION Q BLOCK � � FRAME Q STEEL � �"T <br /> � „ ,,, � <br /> DE3CRIPTION OF WORK �IC /CS f /x � • � TO Yj�f <br /> BU1lDlNG SiZE SQ FOOTAGE[_.�� HEIGHT �_� <br /> QBUl�DING � � VALUATION OF TOTAI.CONSTRUCTION <br /> QE�ECTRICAI. �� � AN1P SERVlCE Q PRQGRESS ENERGY Q W.R.E.C. <br />' �]PLUMBING $� � �� � <br /> NIECHANICAL $ VALUAT[QN O�MECHANICAS.lNSTALLATION <br /> {�,��: <br /> QGAS � RC?OFlNC'a Q SPECIALTY � OTHEFt <br /> FINISHED FLDOR ELEVATIONS ��� FLOOD ZQNE AREA �YES NO <br /> BtI1LDER Cp1�Ip�iPly � _ <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre�s Gcense# r— � <br /> EIEC'1`RtC1AM COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> I <br /> Addeess License# �� � <br /> P�UMBER COMPAiZY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � License# � _ � <br /> MECHANIGAR. "' i COMPANY I � djZ <br /> SIGNATURE �� t���• � REGISTERED Y/ N ' FEE CURRE� Y/N <br /> Address 3 �. � � � � License# � � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> i <br /> Address License# �i � <br /> RESlDENTIAl: Attach(2}Plot Plans;(2}sets of Bultdfng Plaas,{1}sef af Energy�Form`s;12-0=1N Permlt for new consUvct�on, <br /> Minimum ten(10)working;days after submittal date. Requlred onsite,Constructian Plans,Stom�water Pians w/�ilt Fence installed, <br /> Sanitary FaciliUes.&1 dumpster,Site Work Pertnit for subdivisions/large projects <br /> COMMERGlAL Attach(3}comptete se#s of BulldErig Plans plus a i.ife Safety Page;(1)set of Enetgy Fomts.R-O-W Pemtit far new canstruction. <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/SAt Fence installed, <br /> ' SaNtary Facilities&1 dumpster.Slta Work Permit for aA new proJeats.All commereial requirements must meat compllance <br /> SIGN P�RMiT Attach{2)sefs of Erigineered Ptans. <br /> "`"PROPERTY SURVEY required for all NEW construcUon. <br /> Dlrectlons: <br /> ', Fi0 out applicaUon completely. <br /> Owner&Contractnr sign back of appllcallon,notatized <br /> j If oves 52504,a Notice of Commencement[s required. (AlC upgrades aver$7500j <br /> � " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized:letter fram�owner authorizing same__ <br /> � t}VER THE CG1UFlTER PERMiTT1NG �:._-{Front'of Application Onty}, Y ' �,,, „ ` - <br /> �� Reroofs if shingles Sewers,. Seivice Upgrades,-A/C.�', ;`.Fences(PIoUSurvey/Footage) v , � , � ` ' ', , ' , <br /> , a , , .. .. - '� - � <br /> Drivewrays-Not over Counter if ompublic roadwsys.,�eeds ROW A_ �'', � � - - , �.- .,,_,. . , � ' <br />