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i � <br /> � <br />� s�s- so-oo2o City of Zephyrhills Permit Appiication Fax-813-780-0021 <br /> • Building Department <br /> � + l� <br /> Date Received g.— � � phone ContacC for Permitting — C� <br /> /� �/ -Civ L <br /> Owner's Name � � � � . "� � <br /> � / / / Owner Phone Number . <br /> / �(y) �.�Gi ht� / <br /> Owner's Address � /�(1/ � Owrner Phone tdumber /�" / � <br /> Fee Simple 7i leholder IVame Ov�rner Phone Number <br /> �.,t <br /> Fee Simple Titleholder/�4dd[ess <br /> JOB ADDRESS /� / � LOT# � <br />� SUBDIVISIO� PARCEL ID# ' '� � �(�('Qd <br /> � <br />'i (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK,PROP SED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> � INSl'ALL e REPAIR <br /> PROP.OSED SE Q SFR Q COMM � OTHER <br />' TYPE OF COFJSTRUCTION _ Q BLOCK • Q FRAME � STEEL Q <br /> � . <br /> DESCRIPTION OF WORiC <br /> BUILDIidG SIZE _ SQ FOOTAGE� HEIGHT <br /> I . <br /> �BUILDING $�� j 8 VALUATION OF TOTAL CONSTRUCTION <br /> /� <br /> QEL CTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> � 6 V� <br /> �PL MBING $ �U,;.,.�r��; ;�-„i, <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � /�� cS� <br /> � <br /> QGAi � ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED.FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> BUILDER COMPAPIY <br /> SIGNATURIE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAW CONIPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURREF Y/fV <br /> Address License# <br /> PLUMBER:_ COMPAMY <br /> SIGPIATURE, REGISTERED 'Y-/ N- FEE CURRE� Y/N <br /> Address License# <br /> AAECHAPIICAk. , COMPANY <br /> SI�aIdATURE� � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ` .'r; � ` ' � <br /> OTHERa � Ji � COBflPAMY <br /> SIGNA7URE>> y"` REGISTERED / N FEE CURRE� Y/N <br /> Address ��D :� ./, e� ` -• -� License# � i� <br /> RESiDER7TIA�.;." i4ttach:.(2);Plot P,lans;s,(2):sets of-'Building�Plans;-(1)"�set�of•Energy Forms;�R,O-W Permit for new.construction, <br /> :Minimum'-ten;(:10)working:days aftec'subtnittal.date. Required onsite;Construction Plans,Stormwater Plans w/Silt Fence instalied, <br /> Sanitary Facilities•.&,,1.,dumpster Site,W,ork Permit'for;§ubdivisions/large projects � - <br /> COMAAERCI�.L Attach-(2)`complefe"sets'of'Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster..Site Work Permit fo�all new projects.All commercial requirements must meet compliance <br /> SIGN PERMiI i Attacti�(2)sets of Engineered Plans.-,. • <br /> *"**PROPERTY SURVEY required for all NEW construction. <br /> ' Directions: -��-=� � <br /> Fill=out a I plication completely. <br /> Owner&�Contractor sign back of application,notarized <br /> If:over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> " Agemt(foIr the cont�actor)orPower•of Attomey(for tfie.oiivner)would be someone with notarized letter from owner authorizing same <br /> OVER THE CbUNTER PERMI7TIMG ,.. �(copy-of�contract:required) <br /> �....� <br /> Reroofs if shi Igles Sewers Service Upgrades' A/C _,.;Fences(PIoUSurvey/Footage) <br /> , ' .:�.. -;�.,.>_ ..- ..�..._�._�s.: , :. <br /> ,-... .__.._ _..-.••°� ".� <br /> Drivewa -Not over Counter if orn pu6lic•roadways..neecJs.ROW ...._.- , �°�:+�.:�-!' , '! <br /> , ,�, ��f�,- ,.5 't E;C <br /> ��; . .. _ �.','�^ =�;� i . -"%. ;� <br /> '3y:..1,-.:v-:...: .:��,w.��,.-... .�. ��;...,a��:..�-., .;.� <br />