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813-780-Op20 City af Zephyrhills Permit Application Fax-813-780-Q021 <br /> . + 8uilding Department <br /> Date Received � -. '—l phane.Ca�stact far Permlttin ��-� o f� — ��'�� <br /> Owner's Name �'dvv,� �S� Owner Phone Number <br /> Owner's Address Owner Phone-Number �— � <br /> Fee Slmple Tlkleholder.Nama r� � Owner Phane Number �� � <br /> .� <br /> Fee Slmple Titleholder Address �� <br /> JOB ADDRESS � /�l� �`�'�"'��ti'"` S � �_� <br /> LOT# <br /> SUBDIVtSiON n'e� �""''� � PARCEL ID# <br /> (OBTAINED FROM PROPERTYTAX NOTICE) <br /> WORiC PROPOSED � NEW CON5TR ADD/A�T Q StGN [� [� DEMOt,iSH <br /> � INSTALL 8 REPAIR <br /> PROPOSEd•USE Q SFR Q COMM Q QTHER <br /> TYPE OF CONSTRUCTION Q BLOCK ' [� FRAME � STEEL Q <br /> DESGRIPTION OF WORK �e ��"�- ���� ��,..LS�'1,c ��`"•- � 1 <br /> BUILDING SIZE �� � SQ FOOTAGE C� HEIGHT � � <br /> 0����"����'' �'" � VALUATION(JF TOTAL CONS7'Rt1CTION <br /> �_ .J <br /> �ECTRlGAL $ ��-� AMP SEFtVECE Q PROGRESS ENERGY [� W.R.E.C. <br /> QPLUMBING $ , <br /> � � �p 2� <br /> QMEGFiANfCAL $ VALUATt4N OF MECHANIGAL E1�fSTALLATION � � <br /> QGAS Q RQOFlNG Q SPECIAI.'FY � OTHER <br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES NO <br /> BW�DER COMPANIt <br /> SIGNATURE REGI5TERED Y/ N FEE CURRE� Y/N <br /> Address Clcense# � i� <br /> E�EG'iRtC1AN ��,��G_e� COMPANY ��'''S G I-�c.�-vL�-- _SQ.-c�-���' <br /> S I G N A T U R E �' R E G I 9 T E R E D Y/ N F E E C U R R E� Y/N <br /> Address �+�p�- L���=�v ct� t{�S"-" License# Z=C �3 a o 5'y�9't'�� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# �� � <br /> MECHAF11GAl. CCIMPANY <br /> SIGNATURE REC�ISTERED Y/ N FEE CURRE� Y/N <br /> Address ' License# �� � <br /> OTHEEt CQMPANY <br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y-/N <br /> Address � i.icense# � � <br /> RESIDEN'i'IAL - Attach(2),Plo#�!?lans;..{2�sets-af Buililing'Plaos;{1)set of Eriergy�Farin`s;R-O-W Perinit fdr new canstru�ti,on, <br /> Minimum;ten°(.10)�working�days;after,subrriittal date. Requtred ansite,Construchon Plans;Stormwater Plans w/Silt Fence installed, <br /> Sanitery Facilitles.&:1;dum,pster Stte'Work P.errnit fo�suhdivislonsAarge proJects ' <br /> GOMMERCtAL Af#ach{3}c�mplete se#s of Builcling'Plans pl�s a Life Safety!'age;(1}set of Energy Forms.R O-W Permit for new construction. <br /> Minlmum ten(10)working days after submittal date. Requfred onsite,Canstruction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliUes 8�7 dumpster.Site Work Permit for all new proJect's:All commercial requlreme�ts must meet compllance <br /> SIGN PERMIT Attach{2}sets of Englnesred•Plans. _ .� <br /> "'"'PROPERTY SURVEY requlnad for all NEW consUuctlon. <br /> Dlrec#fions: <br /> Fill out applicadan completely. <br /> Owner 8�Contraatar sign back of appltcatlon,notartzed <br /> If over$2500,a IVatice of Commancament is reguired. {NC upgrades over 573d0) � <br /> " Agent(for the c6ntractbr)or Power of Attoiney(fnr the owner)would be someane with notarized letter from owner authorizing same <br /> OVER THE COl1NTER.PERMiTTING (Front af Apptication Oniy} <br /> Reroofs if shingles Sewers Service Upgrades AIC Fe�ces(PIoUSurvey/Foakage) <br /> Drlveways-Rtot over Caunter if on public roadways..oeads ROW <br />