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,. 813-780-0020 City of Zephyrhills Permit Applicatian Fax-813-7 <br /> � Building C7epartment ��1G �';�� <br /> � <br /> Datc�Received � �---�� -- <br /> Phane Contact for Permitting <br /> � a � � �� <br /> �r's Name Owner Phone Number � ' �^ <br /> Owner's Address 1,,. �'�� dwner Phone Number • <br /> Fee Simple Tltleholder Name Owner Phone Number � � <br /> Fee Simple Titleholder Address <br /> JOB ADDf2ESS �� O C�1 � LOT# � <br /> SUBDIVISION ��W �l��Ucei,.) � C�Y;� PARCEL ID# � 1. O- c�v��.�. ' �� � <br /> (OB7AINED FROM PROPERTY TAX NOTICE) <br /> WORK PftOPOSED e NS A�.ONSTR �� REPAIR � SiGN Q MOVE Q DEMOLISN <br /> PRC7POSED USE Q SFR � COMM Q dTHER E.-t2 <br /> TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME � STEEL Q OTHER �� �—� � <br /> DESCRIPTION OF WORK (.,YY�) /'{ ✓U-L2. �L-- ��Z <br /> �—� ���-!��� �., � ( <br /> � BUILDING SIZE SQ FOOTAGE HEIGHT <br /> I <br /> � BUILDING $ � VALUATION OF TOTAL CONS7RUCTION <br /> ,�J7 ' <br /> � ELECTRICAL $ � AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> � �J PLUMRING $ � � / ��%�� <br /> ( xF" <br /> 0 <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� <br /> 0 GAS �� ROOFING Q SPECIALTY Q OTMER <br /> F1N{SHED FIOQR ELEVATIONS � � FLdOD ZONE AREA �YES QNO � <br /> BUILDER r�/ ` '"" COMPAtJY rn11��t� ►l�t� . '� <br /> . <br /> S1Gt�ATURE REGtSTERED / �S FEE GUftR Nf Y IV�� <br /> Address ��t�� �=> �) �-�C.�4 �,,i �t ,�c3�3 License# � ��j�"`�;��Z,.� <br /> ELECTRICIAN COMPANY' <br /> StGNATURE ftE�tSTERED Y I N FEE CURRENT Y 1 N <br /> Address L.icense# �� � <br /> P�UMBER ' COMPANY <br /> SI�NATURE ftEGISTERED Y 1 N j FE�CURRENT Y 1 PI <br /> Address �icense# �T � <br /> "�EGHANlCAL CQMPANY <br /> iNATURE REGISTERED Y/ N FEE CURftHNT Y 1 N <br /> Address l.icense# � � <br /> 4THER CQMPANY <br /> Siloi�i%i t URc (icG�TER�'J � Y i C`! � FEE GURR�Rl7 Y/N <br /> Address 1.icense# � I <br />� p�BupyV�p�psaa�aooahua�upucum <br />{ RES{DEN7]AL Attach{2)Plot Plans;{2}sets of Building Flans;{1}set af Eoeryy Forms <br /> IMinimum ten(10)working days after submittai date. Required onsite,Canstruction Plans,Sa�itary Facilifies&1 dumpster <br /> COMMERCIAL Attach(3)sets of Building Plans;(1)set of Energy Forms, <br /> Minimum ten{10)working days aftet submittal date. Required onsite,Construction P{ans,,Sanitary FaciSities&1 dumpster <br /> All commercial requirements must meet compliance. ` <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ' **'*PRdPERTY SURVEY�eq�tired tor all NEW construcfion. N <br /> _,o �� <br /> rections; <br /> i Fill out appiication comp(etely. <br /> Owner&Contractor sign back of application, notarized <br /> if aver$2500,a Notice of Cammencement is required. {AtC upgrades over$5400) <br /> "" Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter fram owner authorizing same • <br />� OVER THE G4UN7ER FERMITTING {Franf of Afiplieation Only} � <br /> Reroofs Sewers Service Upgrades A/C Fences(PIof/Survey/Footage) <br /> Briveways-Not over Coun#er if on public roadways..needs ROW <br /> . �f <br />