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s�3aso-oo2o City of Zephyrhills Permit Application Fax 813-780-002� <br /> Bu�lding Department <br /> �: . : � <br /> Date Reaelved j tr j f' Pha e-Cantac#for Permttt�n �1� 4�5' - ��� <br /> Owner's Name tt S Owner Phone Number ��3''G 7� r�L�'? <br /> Owner's Address (�LJ TJ ���� �t''"�.Z '�t�✓' /.S � Owner Phone Number � � <br /> Fee Slmple Tltlehalder Name 7� �t �- � Owner Phone Number � � � <br /> Fee S(mpla Titlehclder Address ' <br /> JOB ADDRESS Gt LOT# C� <br /> SUBdiVIS10N � � PARCEL ID# <br /> (08TAINED FROM PROPERTY TAX NOTICE� <br /> WORK PROPQSED „ NEw GON57R ADDJALT Q SI�N Q Q DEMOLISH <br /> e INSTALL e REPAIR <br /> PROPQSED�USE Q SFR Q COMM' [� OTNER <br /> TYPE OF CONSTRUCTION� �] BLOCK ' C] FRAME Q STEEL Q <br /> DESCRIP710N OF WORlt � ,G. ✓)�G''. � � �d� <br /> BUILDING SI2f � � SQ FOOTAGE � ��•" HEIGHT ��� <br /> ,,, ,__, , <br /> $��`���'�' $ VAI.UATIQI�`OF`I'()TAL COIVST'RUCTION <br /> QElEC7RICA� $ �} � AMP BERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> U U' <br /> �PLUMBING $ 'fff_ — � l�{}�� <br /> �MECHAtVlCAI. $ VA�lfAT10N OF MEGtiANICA�tNSTAt.tATlOiV <br /> � pv, U� <br /> QGAS Q ROOFit+lG Q BPECIALTY Q QTNER <br /> FINISHED FLOOR ELEVATIONS �, � FLOOD ZONE AREA QYES NO <br /> BUi�DER COMPANY <br /> SIGNATURE ,,, REG�S7eREo Y/ N FEE CURREA Y/N . <br /> .' License# � � <br /> Address _ <br /> EI.EC7RlClAN �' rtp � COMPANY �.-�,Y�E� <br /> SIGNATURE ��''��%L/L./ �/ REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �- I <br /> P�Ut�IBER � � COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Lic:ense# � �� <br /> _. ., „ , ,,, , <br /> MECHA1�11CAL � COMPANY G�'�1.Uv'� �G � t� �fvl� f�0 � <br /> SIGNATURE �� REGISTERED Y/ N FEE CURRE� Y/N . <br /> Address+ 4icense# � � <br /> OTliER COMPANY - <br /> SIGNATUi2E REGISTERED Y/ N . FEE CURrtE� : Y/N <br /> ,...._„. ,_.,,, <br /> Address Ucense# � � <br /> [tES1DENSlAL` Attaoh(2).Pla#:P1a�s;(2}sets of Bultding"Plans;{1)set of Energy�Forms;R-tO-W Petmit for new constrpc#ian, <br /> MiNmum�ten;(10)working days.aRet.'subrriittal date. Required onsite,Construction Plans,Stortnwater Plans w/S(It Fence installed, <br /> SanftaryFaclQUes.&1.�dumpsterS(te�Work.Rermitfarsubdiv.islons/lat+geproJects - - <br /> COMMERCiAL Attach(3}complete sets of Buitding`Plaris pEus a life Safety Page;{1}set of�nergy Forms.R O-W Permi#far new conswction. <br /> Minimum ten(10)working days'after submittal date. Required onsite,ConstnucUon Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilides 81 dumpster.Site Work Perinit for al!new proJects.All comme�cial.requfrements must meet compltance <br /> StGN PERMlT Attach{2}seis cif Engineered.Pians.� � <br /> ""PROPERTY SURVEY required far all NEW construcUon. <br /> Dlrections: <br /> � . <br /> Fill out applicaUon campletely. � ;� , , � <br /> Owner 8 Confractor slgn back of appifca�on,natarized � _ � <br /> If over 52500,a Notice of Cammencement is required. (AtC upg`rades over ST500j -- �� � � - � <br /> ., .>: ;;.. <br /> '" Agent(for Uie contr�ctor)or'Power of Attomey{for ttie owner)would be�someone with notarized letter from awner authorizing sarne <br /> DVER TNE COUN7ER.RERMiTTiNG � (Fron#of Applica8on On{y} ' ' <br /> Reroofs if shingles Sewers Service UPgrades A/C � Fences(PIoUSurvey/Footage) � <br /> driveways-Not over Counter if on public roadways..needs ROW <br />