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s�sasaaozo C9ty of Zephyrhills Permit ApplRcation Fax 813asaoo�� <br /> , . Bt�ilding DeparUnent - . <br /> Date Recelved �-� "�i( Phone-Cantact for Permittin — <br /> Uwner's Name �.S Owner Phane Number _„_,,,_,r„ _ <br /> Owner's Address c�� G-v r �L Owner Phone Number �� � <br /> Fae Simple Titleholder Name } � Owner Phone Number �— -..� <br /> e <br /> Fee Simple Titlehalder Addrsss <br /> JOB ADpRESS � "�" 4%V .• �L �-- I.OT# ��� <br /> SUBDIVISION � � PAEtCEL ID# <br /> (OBTAINEd FRQM pROPERTY TAX N4TICE� <br /> WORK pROPOSED }NEW CONSTR ADD/ALT �' SIGN Q [� DEMOLISH <br /> � e INSTA�L � REPAIR <br /> PROPOSED,USE _, SFR [`] COMM �� OTNER <br /> 'iYPE OF CONSTRUCTFON BLQCK � Q FRAME [� STEEL [� <br /> t <br /> DESCRIPTION QF WORK ! �1�' <br /> BUII.QING SIZE � � SQ FOOTAGE HEIGHT �� <br /> �UILDiNG $ � � �,`'�".:. �"�.- <br /> VALUATION OF TOTAL CONS'fRUCTION <br /> QEI.ECTRICAt ry � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> L <br /> QPUIMBING �� ���� <br /> � � �� <br /> Q{UIECtiANlCAt. $ VAlUAT10N OF MECHANICAI.thlS'�Ri.LAi'fON � ��� <br /> - � ���,�� <br /> QGAS Q ROOFING Q SPEC1AlTY � OTHEF2 <br /> E{NISHED FI.00R ELEVATIONS �_—� FLOOD ZONE AREA QYES NO j ���( <br /> � ! <br /> . ��� <br /> BUILD R � ,JCOMPANY <br /> StGN 11RE REGiSTERED Y 1 N FEE CURRE� Y./N - <br /> Address Llcense# � i � <br /> r� <br /> ELECTRtC1AN ., COMPANY <br /> SIC�NATURE REGISTERED Y/ N FEE CURREh Y/N <br /> Address � Ucanse# � � <br /> PLUMBER �� COMPANY <br /> SIGNATURE REGlSTEREd Y l N FEE CURRE� Y 1 N <br /> _„_ „, <br /> Addreas License# �� � <br /> MECHANICAL COMP,ANY � <br /> SIGNATURE REGlS7ERED Y�I N FEE CURREA ' Y/N�� <br /> Address License# � � <br /> OTHER _COMPANY <br /> SIGNATURE REGlSTERED Y 1 A! . �EE CURREM1 Y I N <br /> Addre�s License# �� � <br /> �l2ESIDENTIAL • Attach{2)Plcif�Plans;.(2}set�of:Bui2ding`Plans;(i}set of Energy�Farm's;,R-O-W Pemiit for new.construction, <br /> Mintmum,ten°(10��.working;days,after,submltta4 date. Requfred ansite,C+onstructian Flans;°Stormwate�'Pl�ns wt Slit Fence lnstalled, <br /> __ � Sanitary Facilides;&�1,,dumpster Site Work,Rermit for subdiVisions/large projects . ._ � �� - <br /> ~ COMMERClAt. Atfach(3}complete sets of Btiild3ng ptans pius a Life Safeiy Page;(1)set of Energy Forms.R-O-W Permit for new�construcNon. <br /> Mlnimum ten{!0)working days after submfttai clate. Requfred onslte,Constructlan Plans,Stormwater Plans w/Silt Fence instalted, <br /> Sanitary Facilides&1 dumpster.Site Wo�ic Permit for all new`projeafs.All cammereialxequiraments must meet compllance <br /> SIGN PERMIT Attach(2)sets of Eng,i`neeted Ptans.;�.�:•r4� <br /> "*'PROPERTY StlRVEY requlred far al!NEW cansttucNon, , <br /> DireetEons: ' <br /> Ffll out applicatian cor�pletely. <br /> Uwnar&Contractor sign back of applicaUon,notarized <br /> If over y250d,a Nottce of Commencement is required. (A/C upgrades over S750Q) • <br /> " Agent(for th"e cantrabtor)or Power of"AtEomey(for the owner)would be someone with notarized lekter from owner authorizing same <br /> DVER THE COUNTER.PERMITTING (Front of Application Only) <br /> Reraofs if shingles Sewars Service Upgrades AJC Fences(PtatlSuroeylFootage} <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />