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813-780-0020 City af Zephyrhills Permit Application Fax 813-780-0021 <br /> Buitding Department _ <br /> Date Recelved pt�pne Contact far Permlttin <br /> Owrrer's Name �,� (1i � �i,(� Stlt-Q. Owner Phone Namber <br /> Qwne�'s Address � "� 1''L '� ` Own�r Phona Number � � <br /> Fee Slmpie Tltleholder.Name � �� Owner Phone Number � � <br /> Fee Simple Tltleholder Address � <br /> JOB ApDRES3 � � LOT# �� <br /> SUBDIVISION �� � PARCELID# ��f �» .�-�l �d� ��'"� ��� <br /> " (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED 'NEW CONSTR ADDlALT � S1GN Q Q DEMOLISH <br /> e INSTALL 8 � REPAIR <br /> PROPOSED�t13E _� Q SFR [� Ct,}MM � OTHER <br /> TYPE QF CONSTRUC710W , Q # BLOCK � Q FRAME ��] STEEi. Q <br /> DE3Ci21PTION OF WORK <br /> BUILDING SIZE r� � SQ FOOTAGE C�� MEIGHT C�______� <br /> ... .., <br /> BUILDING � � •�.,�-�.:�r- �::.-' <br /> VALUATION QF TOTAC CONSTRUCTION <br /> LECTRtCAI $ AMP SERVECE �Ob ���� <br /> ��� /' Q PRQGRESS ENERGY Q� W.R.E.C. <br /> (/ <br /> o����B,�� �- � - <br /> QMECHANICAL �;��, VAlUAT10N L?F MECHAN{CAL.INSTALLATION <br /> L <br /> O� O ROOP[NG Q SPECIA�'i'Y � t3THER <br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA QYES NO <br /> BUiLDER COMPANY+ <br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N , <br /> Addres� � License# �� � <br /> ELECTRiC1AM G,r4r,�'" "1 ', COMPANY <br /> SIGNATURE REGI3TERED Y/ N FEE CUftRE� Y/N <br /> � Addre�s c��l Ltcense# LCaB �26� � <br /> PLUMBER COMP.ANY <br /> 51GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre$s .License# � � <br /> MECHRNICAL COMRANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> ' Address License# r � <br /> il 13THER COMPAhiY <br /> SIGNATURE � ReciSrEREo Y/ N . �EE cuR�n Y-/N. <br /> Adcdress � License# � � <br /> RE8IDENTfAt. Attach(2}Plot Plans;{2}sets af.Biiilding'Plans;{1}set af Eneigy�Forms;,R-O-W Petmit for new construct3an,, <br /> Minlmum�ten(10j,working;days,after,subriiittal date. Requlred onslte,CanstrucHon Plans,Stormwater'Plans w/Silt Fence installed,, <br /> -~ - � � SanlfaryFao'sltUes,&1clumpster:Site`Work�Rermitforsutidivislonsflargeprojects = - <br /> CON{MERCJAI. Attach(3}camplete sets of Suitdirig'Plans plus a Life Safeiy f'age;(1}set of Energy Forms.R-O-W Permit far new cbnstruction. <br /> Minimum ten(10)wo�lcing days after submfttal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary.Facilitfes&1 duinpster.Site Work Permlt tar all new projects.Aii cammerciai�equirements mus#mest t�mpifance <br /> SlGN PER[�iT Attach{2)sets of Eogineered Ptans.;_ � ry <br /> '•""PROPERTY SURVEY required for all NEW constructlan. <br /> Directlons: <br /> Ftll out applicaBon rampletely. <br /> Owner&Contractor slgn back of apptication,natarized <br /> If over a280d,a Notice of Commencement ls required. (AIC upgrades over�T500) <br /> " Agent(for the contracto�)`or Power of Attomey(for the owner)would be sameone with notarized letter fram owner authoriztng same <br /> OVER THE COUNTER PERMITTiNG (Front of Appiication Only) <br /> Reraofs if shingles Sewers Service Upgrades AIC Fences(Plot/Survey/Footage) <br /> Drlveways-Not over Counter if on public roadways..needs ROW <br /> —J <br />