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813-780-OD20 City of Zephyrhills Permit Appiication Fax-813-784-OQ21 <br /> � �� �:. Building Department <br /> � <br /> �: _�.'ar-:. . <br /> Date Received J phone Contact for Pertnitting <br /> a • <br /> �Owner's Name� .,Q / � (/`�/�`� ��'"� Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> 1 �— � <br /> Fee Simple 7itleholder Name � __� Owner Phone Number <br /> , <br /> � <br /> Fee Simple Titl�eholder Address <br /> ? ��� �.{.(rQ. LOT# C�.� <br /> JQB ADDRESS <br /> SUBdiVtS10N ;� � � �,a�c����� �02 �'��- l��t��-o� c�b �r� `"'D <br /> (OBTAIPIED FROM PROPERTY TAX NOTICE) <br /> WOt2K PFtOP�SED , NEW COHSTR ADDIAl.T 0 SlGtV Q Q DEMOLtSH <br /> � e INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q GOMM � OTHER <br /> TYPE`'OF CON8TRUCTION Q BLOCK - Q FRAME �] STEEL Q <br /> DESCRIPTION OF WORK `�'`�� C�! 1� �"�� 'PY' Q�cl� �-�- ��' `�' l~ <br /> BUICDING SIZE �— � SQ FOOTAGE HEIGHT �� <br /> t 0����fl�� $ j�� � VALUATION•OF TC?TAL GONSTRUCTION <br /> f <br /> LECTRtCAt $ AMP SEF2VICE f� � PROG ESS EiVERGY Q W.R.E.C. <br /> �P�U� BING $ � , � <br /> � � , ���� <br /> �ME HANtCAL $ VALUATtON 4F M�CHANICAL lIVSTALLATiO(V � <br /> � <br /> �GA� Q RQQFING Q SPECIALTY 0 QTHEi� <br /> FINISHED FLOOR ELEVATIONS FLOQD ZONE AREA QYES NQ <br /> � <br /> BUILDER ' CO{M�PANY <br /> SIGNATURE ; REGISTERED Y/ N FEE CURRE� Y/N <br /> Addressl License# � � <br /> EI.ECTRtG1AN If � , COMFAFlY <br /> � 'G-e�� <br /> SIGNATUF2E �,~ REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �'� ��—�U!���� <br /> PLUMBER ' COMFANY � <br /> SIGNATUi2E 'REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> NiECHANIC , COMPAtdY <br /> SIGNATURE� REGISTERED Y/ N FEE CURRE� Y/N <br /> Adilress License# � <br /> OTFiER= "�` CQM!?ANY <br /> SIGPIATURE � . REGIS7ERED Y/ N ., FEE cuRR�� Y/M <br /> - Addres License# � � <br /> �� <br /> ' RE31DEN7'IAiL . Attach(2):Plot Plans;{2}�sets of Bu3lding�PEans;{1)`seYa#Energy Forms;f2,Q-W Permlt far new canstruction, <br /> Minimum,,ten(10)working;days after submittal date. Required onsite,Constniction Plans,Stormwater Plans w/Silt Fence installed, <br /> � Sanitary,Facilities&1 dumpster;Site Work.Permit for subdiv:sionsAarge projects - <br /> � COMMEI2CI,�L Attach(2}camptete'sets of Builiting Plans�plus a Life Safety Page;{1}se#af Energy Forms.R-O-U1f Permit for new construct�on. <br /> � Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Siit Fence installed, <br /> Sanitary Facitities&1 dumpster.Site Waric Permit fot aii new projects.AI{commercia!requirements must meet compliance <br /> SiGN PERMIT i4ttaah(2}sets of Engineered Pians. <br /> `*"PROPERTY SURVEY required far aII.NEW construction. <br /> Diirections: ' - <br /> Fill aut�pplication campletely. ; ' ' <br /> Owrser&Contractor s9gn back of appiication,notar�xed . <br /> If over�25Q0,a Notice of Commencement is required.;-�.(AlC.upgrades over$75d0j <br /> *' Agent(forth'e c,�ntractorj or.Power of Attomey(forttie owner)would'be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI'ITING (copy of-con#ract-requir'ed} <br /> Reroofs If shingles Sewers Service Upgrades AIC Fences(Plot/Survey/Footage) <br /> � .. , ., ...-, ... .< < . <br /> Driveways-Nofover Counter if on public roadways..needs ROW <br /> � � -- <br />