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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Buflding Departrnent . <br /> r : .. <br /> Date Received . Phone-Contactfor:Permittin '°, - -�- - <br /> I . ,,`. -: -• - <br /> Owner's Name � 't,v-�- s<</cl C Zv ' ' Ovvner Phone Number . - <br /> Owner's Address !V U� � � �OwnerPhone Number - <br /> Fee Simple Titleholder Name � - Owner Phone Number <br /> Fee Simple Tltleholder Address °' <br /> JOB ADDRESS �� 0 ✓����`C. � V� LOT# � � <br /> SUBDIVISION S i`I v L� o�I� PARCEL ID# � 3 '- Z�U — —O �G —O�O�U —d6 S b I <br /> � (OBTAINED FROM PROPERTY_TAX NOTICE), <br /> WORK PROPOSED '� NEW CONSTR ADD/AL'T Q SIGN Q � Q DEMOLISH � - <br /> B INSTAtL B. REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION' Q BLOCK �' Q FRAME � STEEL Q _ <br /> DESCRIP710N OF WORK T j��`v D¢ � (� 1`�+- l �`�ID tv I r 1n� f�C <br /> BUILDING SIZE SQ FOOTAGE �0 HEIGHT : <br /> M1t'..-+F1..;W�.... -A1+-_-..-:^" <br /> QBUILDING $I S.O OD� O(� VALUATION�F-TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE ` Q PROGRESS ENERGY [� W.R.E.C. <br /> QPLUMBING $ <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � I � � �� <br /> OGAS ROOFING. .Q SPECIALTY Q OTHER � ��� <br /> c���� . <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES: NO � ,� 1� <br /> /v <br /> BUILDER COMPANY <br />' SIGNATURE REGISTERED Y/ N FEE cuRtt�n Y./N <br /> Address License# <br />, ELECTRICIAN - COMPANIf - <br /> SIGNATURE ""' REGISTERED Y/ N FEE CURRE� Y/N <br />' Address • � -.Llcense# � <br /> PLUMBER _ COMP.ANY- •.' <br /> SIGNATURE � REGISTERED . Y/-.N FEE CURRE� Y/N: - <br /> Address License# . <br /> MECHANICAL � . , COMPANY , <br /> SIGNATURE " � � ` " se�isTer�o Y:/ N Fee Cuw�En Y/N-, <br /> Address- - �� � � <br /> License# <br /> OTHER COMPANY G��.Y3.[�lilC�a�..._. (�'" , <br /> SIGNATURE. ' ' ' ` � <br /> REGISTERED Y/ N v ,- „�e cuRt�n , Y/.N>. . <br /> Addre�s �� (��.D�C:_��� ;�.,� S'ti�i:: lAyr n•� ��. �33s7b License# GC�LO�7 !�'�� <br /> RESIDENTIAL•. �Attach,(2)4PIot:.P,lan's;;.(2)sets:of<Building'Plans;.(1)setofEnergy�Fortns;.R-O=W°Permitfornewconstrucdon, <br /> Minimumaten:(1sU)iworking;days:a(te�;'sutimittal:date.�.Requlred onslte;�ConsfnicBomPlans;Sto'rmwater Plans w/Slit Fence installed, <br /> Sanitary�Faciliti,es:&,,1{dumpster_:SiteFWoricµPerrnit.#or`sutidivisions/large'pro]ects��:�•:;::°�:� ' � °" � - `` <br /> COMMERCIAL Attach(3)`compl'ete sets of Bullding"Plans plus aTL(fe Safety�Page;(1)set of Energy Forms.R-O-W Permit for new oonstructlon. <br /> Minlmum ten(10)working days after submlttal date. Requlred onslte,ConsUucUon Plans,Stormwater Plans w!Sllt Fence Installed, <br /> SanlNary Facllldes&1 dumpster.Slte Woric Permlt for alPnewiprojeots:All commercial.requlrements must meet compllance <br /> SIGN PERMIT AttacFi(2).sets of'Hnglneer,ed=Plans;�:;;;%-�< ., _ .... <, _ - <br /> "'•PROPERTY SURVEY reguired for all_,NEW,consWctlon..�. . <br /> . Dlrectlons: , `?:�._ � .. . - ' <br /> FIII out appflcatlon completely. . <br /> Owner&Contractor slgn back of applicadon,notaAzed <br /> If over E2500,a Notice of Commencement ia requlred. (AIC upgrades over�T500) s „ <br /> . �.;..-:_�,..;:.:��: � . <br /> " Agent(for the�co�Vactor)`or Power of Affoiriey(fo�fFie owner)would be�someone with notarized letter from owner autho�izing same <br /> 'OVER THE COUNTER�P.ERMITTING�� -•-:-(Front;of-Appllcation Only) • � � � ' " <br /> Reroofs If shingles Sewers Servlce Upgrades A/C Fences(Plot/Survey/Footage) <br /> Drlveways-Not over Counter If om publlc roadways.:needs ROW � � <br />