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813aso-oo2a City of Zephyrhills Permit Application Fax 813-780-p021 <br /> ' Building Department . <br /> Date Recelved � �i � 'Phone Co»taet for'PermittEng � �(� �' — � <br /> Owner's Name �f � Qwner Phons Nambet �l�' ' (�__1�� <br /> � . <br /> Owner's Address ��23 � Owner Phone Number � <br /> Fee Simple Titleholder Name r— � Owner Phane Number �^ � <br /> i . _ <br /> I� Fee Simple Titleholder Address _ <br />�I JOBADDRESS ��.�,� G�'. LOT# �� <br /> i <br />' sueorois�oN. Sru,s�a- �,�5�.,� � PARCEL ID# ` ��� �- �-(- 3 r�- d�- 2 <br /> (OBTAINEd FROM PROPERTY TAX NOTICE) <br /> WORK PROPC}SED NEW CONSTR ADD/AtT' Q SiGM1! � Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> PR4Pt?SED USE � SFR a CQMM Q C?THER , <br /> TYPE QF CONSTRUCTION Q BLqCK " Q FRAME G� STEEL Q �, <br /> DESCRIPTION OF WORK S �9 �.. R� 1 � � �t U' i cxc. ` � ay . � ��� <br /> Htl1CD1NG SIZE �� � SQ FOOTAGE C_� HEIGHT [_,.r�,� <br /> 64l1LDING � �� VALUAT�ON OF TOTAL CONS7RUCTION <br /> �� �"' _..J , <br /> QE�ECTRICAL �� AtVtP SERVICB Q PROGRESS EhtERGY [� W.R.E,C. <br /> QPLUMBING '�'' <br />'� C ,- � � � �775 <br /> QMECHANICA� $ VA#.UATION OF MECHANICA�INSTAI.CATIC?N <br /> OGAS Q ROQFtNG. Q SPECIAt,TY � O'FHER <br /> FINISHED FLOOR ELEVATIOPIS ��� FLOOD ZONE AREA [�]YES NO <br /> 8U1lDEit ,. ,,�j ff . COMPANY F'�� �t.�d- <br /> SIGNATURE k�` � � REGISTERED Y/ N FEE CURREP Y/N <br /> Address !�$t �'� ((ta.��c� License# �~ ,� �!�S.� � <br /> ELEC7RlCIAN COMP"ANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � License# �� � <br /> P�U[�t38ER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> �i Address � License# � ' � <br /> MECHAPIICAI. , COMPAMY <br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N <br /> , Address License# �r � <br /> OTHER ..COMPANY <br /> SIGNATURE REGISTERED Y/ N , FEE CURRE� Y/N <br /> Address ` License# � � <br /> I2ESlDEN'i'IAl; Attach(2)Plof Plans;.(2}se#s of Bullding�Plans;(i}sef of Energy Farms;R-0=W Perinit far`new constniction, <br /> Minimum�.ten�(�1.0)�working,deys after�submtttal date: Required onsife,�CansUucNon Plans,Stormwater Plans w/Silt Fence installed, � � <br /> Sa�itary Facilitles;&;1,;dumpster•Slte Wo�1c=PermlYforsubdivisio�sAarge proJects <br /> COlUIMERCIAl. At#ach{3}comple#e sefs af Building�PEa"sss ptus a Life Safefy+Page;{1}set af Energy Forms.R O-W Penni#for new c�nstrucHon. <br /> ' Minimum ten(10)working days'after submittal date. Required onsite,ConstrucUon Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facili8es&1 dumpster.Site Work Permit tor aU new proJects:All commercial requirements must•meat compliance <br /> SIGN PERMl7 Attadi{2}'sets df Engineer,ed Plans.:., ,f <br /> "`"PROPERTY SURVEY requlred for all NEW cpnstrucBon. <br /> Dlreatlons: � <br /> Fill out applicaUon completely. <br /> Owner&Contractor slgn back of applfcaaan,notarized .. ......... .. .. . .:_: .. . _ __ ;:.,, <br /> If over 52500,a Notice af Commencement is reqaired. (A/C upgrades over�7500) i „ " <br /> :• 6' � <br /> '" Agent(for tfie contractor)or Powe�ofAttomey(for�the owner)wauld be someone with�otarized letter from"ouvner autho�izing sam�� I`f="- <br /> �; . _ . r, <br /> DVER i'HE CQUNTER PERMI'i'LfNG {FraM af Application On4y} �� �, ��r, . . • _• • ;; <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIaUSurvey/Footage) ' ` �••"� �}�• • �•-��� �=. .0� �� I <br /> Driveways-Nat aver Counter if on pub8c roadways..�eeds ROW <br />