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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Buiiding Department <br /> Date Rgceived *�",.�—f� pnone Contact for Perm[tt[ng <br /> Owner's Name ��t�2 �G�tiP t! Owner Phane Number ���"����'" y��/ <br /> Owner"s Address ����' �7h �'/ ' �e � �yi� �-� Owner Phone Number �— � <br /> Fee Simple Titleholder Name r� � Owner Phone Number �— � <br /> Fee Simple Tftleholder Address <br /> JOBADDRESS s��b ��� �y �� � N�'l�s LOT# C� <br /> SUBDIVISION � � PARCEL tD# f �"a6' a t`�'���-' �'o'`�6�� " Q� O <br /> (OBTAINED FROM PROPERTY TAX NOTICE1 <br /> WORK PROPOSED e NEW CONSTR� ADDlAL.T C� SlGN Q Q DEMOLiSH <br /> INSTALL REPAIR <br /> PROPOSED llSE Q SFR Q COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEI [� <br /> � <br /> DESCRIPTION OF WORK �}QSC h� G ti+.l-N G� � � ivl-�' 0.N c� ,�d �� �2� <br /> BUILDiNG SIZE �p X��'-� gQ FOOTAGE 7 7 �' FIEIGHT �.,_ � � <br /> 0$�t��1�� $ t p�(j�, �`--' VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL � � AMP SERVlCE � PFtOGF2ESS ENERGY Q W.F2.E.C. <br /> OPLUMBING �� � <br /> �1���� <br /> QMECHANICAL $ VALUATIC}N OF MECHANtCA�tlVSTALLATiON <br /> OGAS Q ROQFING C] SPECIALTY �� OTNER <br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA QYES NO <br /> BUIlDER .� a ` �. COMPANY ��� ��l �,N Cc�"'�.Qt,��t`�..s �;c'. '��, <br /> SIGNATURE � � \ ; ) REGISTERED N FEE CURRE� Y/N <br /> Address �� d� o�i� „� ��,t,� (�,�- License# �(yGo y�7 0�-��� <br /> ELECTRICiAN � COMPANY <br /> SIGNATURE REGI3TEREp Y/ N FE��CURREA Y/N <br /> Address LiGense# �^ I <br /> PLUMBER � CQMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— � <br /> MECHANtCAl. COMPANY <br /> $IGNA7URE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> OTHER � � CtIMPANY <br /> SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N <br /> Address License# � 1 <br /> RESIDENTIAl. Attach{2}Ptot Plans;(2}sets of Building Plans;(1)se#of Energy Farms;12-Q-W Permit far new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsllarge proaecis <br /> COMMERCtAI. At#ach{3}comptete sets of Buitdfng Ptans ptus a�ife Safety Page;(1}set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days afker submfttal date. Required onsite,Canstruct)on Plans,Starmwater Plans w/Silt Fence installed, <br /> Sanitary Faailities&1 clumpster.Site Work Permit for a0 new prajects.AI!commerciai requiremenis must mest compliance <br /> StGN PERMtT Rtkach(2}sets of Engineered Ptans. <br /> "'""PROPERTY SURVEY required for all NEW construction. <br /> � Directions: <br /> Fill out application completely. <br /> � 4wner&Contractor sign back af appf'scation,notarized <br /> If over b2800,a Notice of Commencement is required. (A/C upgrades over 57500) <br /> "" Agent(for khe contractor}or Power of Attomey{for the owner)would be someone with notarized letter from owner authoriz�ng same <br /> OVER 7HE COUNTER PERMiTTING (Front of Appilcation Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Foatage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />