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a�aa o-oo2or � City af Zephyrhills Permit Application Fax-813-780-0021 <br /> . Building Deparkment <br /> Date Received Phone Contact for Permi#ting � - <br /> f �O+xne�'s Name ��N,���` ��� '�' D�""' r � Owner Phone Number f. "'� � ���� <br /> Owner's Addre s r/�` -+� �"� �A"'r� � i " � Owner Phane Number �1r7'""���� ����r��`Z- <br /> Fee Simple Titleholder Name �� � Owner Phane Number � � <br /> Fee Simple 7it eholder Address <br /> JOB ACIDRES 1 a��"L � G.�1 C�Cf �� � {1I� LOT# ��� <br /> SUBDNISION�. �- � PARCEL ID# ��f�G������l�� �tO���@��� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP SED e . NEW CONSTR 8 ADDtALT [� SIGi3 Q Q DEMflC.ESH <br /> INSTALL REPAIR <br /> PROFOSED U E Q SFR Q COMM �� OTF{ER <br /> TYPE'OF CONSTRUGTION Q BLOCK • Q FRAME � STEEL Q " <br /> DESCRIPTIO � OF WORK � 1% V w x�'+�' '�1 � C9 U� <br /> BUI[DING St � � SQ FOOTAGE� HEiGHT C-T� <br /> Q8U1 DiNG r> � VAWATIOIV�t3F`TOTAL CONBTRUCTION <br /> L � <br /> QELE, TF2ICAL � � AMP SERVICE Q PROGRESB ENEFiGY Q W.R.E.G. <br /> i <br /> QPlUMBENG $ �6 � ��t <br /> �ME, HANICA� $ ff���r �, VALUATtON C7F MECNANICAL tNSTAlLAT10N ��j � <br /> Z ".y <br /> �GA� � FtOOFING Q SPECIALTY � OTHEFt <br /> FINISHED FL� OR ELEVATIONS r�---� FLOOD ZONE AREA [�YES NO <br /> L <br /> Bt31LDER r� COMPAt+tY <br /> SIGNATURE REGISTERED Y/ N FEE CUF2RE� Y/N <br /> Address License# �! � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE� ' REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � ¢ � <br /> PLUMBER ' COMPANY <br /> SIGNATURE 'REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres` � License# �^ � <br /> MECHANIC CQMPANY �'P�i{� l�tS. G� �� �►!'4;��+$'S <br /> SIGNATURE REGISTERED / FEE CURRE� /N <br /> Addres ' �D �I �157� c" vj �iO�G��'[. �j �3 �3 License# (.��� � r��,g��r� <br /> OTHEit� � � COtVlPANY � <br /> SIGNATURE'r: - REGISTEREp Y/ N FEE CURRE� Y/N <br /> Addres . - License# �� , � <br /> i2ESIDENTI. - Attacfi'{2}:P1of P.lans;`(2}':sets of-Buifiiiing=i'tans;{1}set'ofEnerg}r Forms;R-O-VY Permlt.for new constructian,. <br /> , Minimumften:(.1q)working;days'after submittal date. Required onsite;Construction Plans,Stormwater Plans,w/Silt Fence installed, <br /> � Sanitary,Facilities�8�=,1.dumpster.;Site Work Permitfocsubdivistons!large.projects � ' <br /> COMMERCI Attacfi�(2}comptete sets of Building Plans plus a Life Safery Page;{1)se#of Energy FoRns.R-O-W Perm9t for new construction. <br /> Minimum#en(10)workirig days after submittal date. Required ansite,Construction Plans,Stormwater F'lans w/Silt Fence installed, <br /> Sani#ary Fac[lit�es&3 dumpster.Site Wark Permit fot atl new projacts.Rii cammerciai requiremec�ts must meet cosnp{iance <br /> SIGN�PERM T Attach(2)sets of Engineered Plans.� <br /> ° •�**PROPERTY SURVEY required for.all.NEW canstruction. <br /> � Directions: - <br /> Fill out pplicatlon completely. <br /> Owner Cantractor sign back af applicatian,no#arized <br /> If over 2500,a Notics of Commencement is required. (AIC upgrades over$750q) <br /> '* Agent( `r th'e cantractor)ar Power of At#omey(for the owner)would be someone with notarized letter from owner autk�orizing same <br /> OVER.THE �OUNTER PERMITTING (copy af-contract required) <br /> Reioofs if sh ngles Sewers Servloe Upgrades A/G Fences(PIoUSurvey/Footage) <br /> Dcivew ys-Not over Counter if an public roadways..needs ROW <br />