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� � i <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> I Buildfng Department <br /> �� <br /> i Date Recelved Phone Contact for Permltting ��� �$Z 0-(� <br /> � Owner's Name �arM1i II� ��Q � Owner Phane Number <br /> I Owner's Address �J � �(�i✓�} �, d� Owner Phone Number <br /> j �e Siinp(e.TiileBofder Name Owner Phone Number � <br /> IFee Simple TiBeholder Address <br /> JOB ADDRESS �Lc31 � �,r�y'l�1� e V . Z � "l Z LOT ii � <br /> SUBDIVISION ff.���l I I T�� � pARCEL IDi� �/2��"C�Z�'wlJ�"-� �1� <br /> (OBTAINED FROM PROPERTYTAX NOTICEj <br /> WORK PROPOSED e NEW CONSTR e AOD/ALT 0 SIGN Q Q DEMOLISH <br /> iNSTALt REPAtR <br /> PROPOSEDi35E '� SFR � GOMM 0 OTHER ' <br /> TYPE OF CON5TRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF FNORK JV 1� Q��G <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> UILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMF SERVICE. Q PROGRESS ENERGY Q W..R.E.C. <br /> � <br /> � OPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS � ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUI�DER COMPAMY Pau sC�.et,per � <br /> SIGNATURE � REGISTERED / N FEE CURRE� /N <br /> Address �Q"L l;�.Q,�� cs�q � License# �J <br /> ELECTRICIAN COMPANY <br /> SIGNATURE rtE�ISTEReo Y/N FEE CURREA Y!N <br /> Address License# <br /> ���� CONtPANY <br /> S�GMQTURE a�c�sr�n Y7 N FEE CURRE� Y/N <br /> Address License# -1 <br /> MECHANICAL COMPANY <br /> SIGNATURE RE�ISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED �Y I N FEE Cl1RREA Y/N <br />, Address license# <br /> IIIIIIIIIIIIIIIYIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new constructlon, <br /> Minimum ten(10)working days after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fenca installed, <br /> Sanitary Facllities 8 1 dumpster;Site Work Permit fo�subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction. <br /> Mlnimum ten(10)working days efter submittal date. Required onsi[e,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercfal requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW constructlon, <br /> I DlrecNons.. <br /> FIl out applfcation compfetety. <br /> Owner 8 Contractor sign back of application,notarized <br /> � If over$2500,a Natice of Commencement Is requlred. (AIC upgrades over$7500) <br /> " Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> � OVER THE COUNTER PERMITTING (copy of conUact required) <br /> IReroofs ii shingies Sewers Service Upgrades A/C Fences(PIoUSurveylFootage) <br /> � Driveways-Not over Counter if on public roadways..needs ROW <br /> I <br /> I <br /> L � <br />