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s�s-7ao-oa2o City af Zephyrhills Permit Application Fax 813-780-ao2� <br /> � . Buflding Depattment <br /> Date Received phone Cantaef for Aermiftin <br /> Owner's Nama �� L � Owner Phone Number <br /> Owner's Address �a� �� Ll2 � L�l� ���� Owner Phone Number �- � <br /> Fee Simple Titleholder Name Owner Phane Number �� � <br /> Fee Slmple Titleholder Address ' <br /> JOB ADDRESS ���� D��s� � � rh � S —�-- 3�5�� LOT# �_T� <br /> SUBDIViS10N � � PARCEL ID# <br /> ' (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED , e ¢ NEW CONSTR� ADD/A�T � S1Gt3 [� [� DEM�USH <br /> INSTALL. REPAIR <br /> PROPQSED,ilSE Q SFR Q Ct}MM [� 4TFiEF2 <br /> TYPE QF CQNSTRUCTION Q BLOCK ' Q FRAME C� STEEI. [� <br /> DESCRIPTIQN OF WORK �'Q- r�' <br /> BUtLDING SIZE � � SQ FOOTAGE HEIGHT . ,,_, , <br /> C� � � <br /> _.., . . . <br /> BU11.D31VG $ /, � �4-��. <br /> �� � VALUATION C1F TOTAL CONSTRUCTION <br /> [�Ei.ECTRICAL � � AMP SERVICE Q PROGRESS EhlERGY Q W.R.E.C. <br /> QR�.UMBING �� <br /> Q � VAI.UATIOhi C1F MECHANICAI INSTA�IAi'IOtV <br /> MECH,�WICA�. $ <br /> , ,..., - <br /> QGAS � ROOF{NG Q SREGIA�'fY � OTHER <br /> FINISHED FLOOR ELEVATIQNS r�� FLOOD ZONE AREA QYES NO <br /> L <br /> BUt1.DER ���c� C� CQMPANY ���t1 �S� �-"� <br /> SIGNATURE REGISTERED Y/ FEE CURRE� � Y/N .- <br /> Address License# � � <br /> �LECTRICIAN - CAMPIINY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address license# � � <br /> PLUM�ER Ct1MFANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# I � I <br /> MEGHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre�s� License# �� � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N_. Fee CUR�n Y/-N. <br /> Address License# � � <br /> �- � <br /> RESlt?ENTfAL °Attach(2),Flo#f!lans;,(2}sets of:Bultding'Flans;'{1}set of Eriergy>Facins;R-O-W Permit for`new construction, <br /> ' Minimum,ten�(:1.0)�working;days:after,subrriittal date: Required ansife,Construcaon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Faci�ilUes:&�,1„dumpste.r,,Site Work:Pemnit for sutididi'siansAarge,'proJects `° <br /> COMMERCIAL A#tach{3}complete'sets of Buitdtiig P4ans ptus a Life Safe#y Page;{1)set of Enetgy Forms,R-O-W Pem�it for neuv canstruction. <br /> Mlnimum ten(10)worktng days after submlttal date. Required onsite,Construcdon Plans,Stormwater Plans w/Si�t Fence installed, <br /> 8anitary Facilides�1 dumpster.Site Work Permit for all new proJects:All commercial requlremersts must meei compllance <br /> SI�N PERMIT Attach{2}sets 6f Engineered Plans..:� ^ � . <br /> ""'PROPERTY SURVEY required for all NEW construatPon. <br /> Dlrecttons: <br /> Ffll out application completely. <br /> Owner&Conirac:tor slgn baek of applEcaflos,natarfzet! <br /> if over$2500,a Nattce of Cammencement is reqaired. (A/C upgrades over ST500j <br /> �t;"'d:, . <br /> " Agent(for the contracfor)or Power of Attomey(for the awner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER.PERMiTtiNG (Front of Application Only} <br /> Reroal`s ff shingles Sewers Service Upgrades AlC Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />