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t� ' <br /> 813-780-OQ20 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> - Building Department <br /> Date Receivedl .�"� Phone Contact for Permitting � <br /> Owner's Namo � �-(�- �S z-- ` Owner Phane Number . "7 -.� 3- <br /> Owner's Address SE7c.��.. �-t�S Z Owne�Phane Number �- � <br /> '� � � <br /> Fee Simple Titleholder Name �.r G c� 'c. Owner Phane Number <br /> i <br /> y � <br /> I <br /> Fee Simple Titleholder Address <br /> il r'�JOB ADDRESS � C��2 •� � 2�, 1� \� LOT# � <br /> ,i (�� j�, <br /> suBoivisiaK�- I � �aRCE�,io# r <br /> (OBTAINED FROM PROPERN TAX NOTICE) <br /> WQft1C PROPOSED e . IVEW CONSTR 8 ADD1At�T �� SIGN Q � DEMC}�ISN <br /> � INSTALL REPAIR <br /> PRQP.QSED USE Q SFR [� CONiM � OTHER <br /> TYPE'OF CO�STRUGTION Q BLOC - FRAME 0 STEEL [� - <br /> DESCRIPTIO�OF WORK ,.� F _ <br /> BUI�t3tNG SlZE SQ FOOTAGE�� HEIGHT F'�' <br /> �BUILDtNG � <� ��_ � VALUATtON°OF TOTAL CONSTRUCTION <br /> �. �.� I <br /> QELECTRIGA� $ � AMP SERVICE Q PROGRESS ENERGY 0 N1.R,E.C. �t�tj� <br /> � p� / �-S�� r�W <br /> �,17 ��''�''� � <br /> �PI.UMBtNG $ �1�1 1 <br /> QME�HANECAL $ VA�.UATION OF MECHANlCAL INSTALiAT10N ���� � � <br /> 'I � � <br /> QG1il` Q RQOFING Q SPECIA�TY [� OTHER � �,�,_j„Z+�- <br /> ����A <br /> FINISHED.FLOOR ELEVATIONS FLOOD ZONE AREA QYES N f����� <br /> i <br /> BUILDER , � /"COMPAM' � <br /> SIGNATURE� REGISTERED Y/ N FEE CURRE� Y/N ~` <br /> Address� „��-a,?�-I License# <br /> ! i <br /> E�ECTRICIAN COMPAFIY <br /> SIGNATURE� � REGISTERED Y/ N FEE CURRE� Y/N t <br /> Address Liaense# <br /> PLU3UDBER; CQ1tAFA�QY <br /> SIGNATURE' �REGISTERED Y/ N FEE CURRE� Y/N <br /> i � <br /> - Address License# �- � <br /> � , <br /> NlECHANICA� COMPANY <br /> SIGNATURE'� REGISTERED , Y/ N FEE CURRE� Y/N <br /> i <br /> Add�es� License# <br /> 4�Hf'iR�t� ���'� COMPANY - <br /> IGNATURE j� -'�-'� I REGISTERED Y/ N FEE CURRE� Y/N � <br /> � r!:r►�� <br /> q � ��s$ p License# <br /> i� <br /> RESIDEN11A1.= Atfach�2},Piot P,lans;'(2}:sets of Buildiitg-Placts;{4}'set of Energy Forms;R-Q-W Permit for new cansbuction, <br /> , .. , ;Minimum:ten�(.10)working;days after'submittal dafe. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence ins#alled, <br /> � Santtary,�acilitias,&,1:�dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach�(2}'comple#e sefs of Bui1cl�ng Ptans plus a L'sfe Safety Page;(1}set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal dake. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> � Sanitary FacHities F�1 dumpster.8ite Work Permit fo�a!{new proJects.Ail commerciai requirements must meet comptlance <br /> SlGN PER�At� Aftach(2}rvsets of,Engineerec3 Pians. > <br /> '*'*PROPERTY SURVEY required for_all NEW canstructian. <br /> Directions: � �- <br /> Fill out application completely. <br /> Owner 8�Gontractor s9grt back of applicat'son,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> *" Agent{for th'e cont�actor)or Power�of Attomey{for tfie prvner)would be someone with notarized letter from owner authoeizing same <br /> OVER THE C�QUNTER PERMI'RING (copy of.contract required) <br /> Reroofs if shifngles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) � <br /> Drivewa�s-Not over Counter if on pubiic roadways..needs ROW <br /> ,� <br /> � <br />