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i, <br /> a��-�ao-Qo2o City of Zephyrhills Permit Application Fax 813-780-002� <br /> {i Building Department <br /> fl <br /> Date Recaivsd I) �b �p Phone Contact for Permitting - <br /> Owner's Name�i C� 1C. �„ Owner Phone Number � f3��,.-r��„� , <br /> ;� I � � <br /> Owner's Address � �� han ✓� j�G G1'� �, Owner Phone Numbar <br /> IfI <br /> Fee Simple Titleholder Name Owner PhonQ Number <br /> Fee Simple Tit�aholder Address <br /> JOB ADDRES 'i O� i�1Q �� Q+ V1 ~i� LOT# �� <br /> SllBDIV1310N � � PARCEL ID# � -r�J"'��'��c�a"' 1�`1�/c7 <br /> {OSTAINED FROM PROPERTY TAX NOTlCB) <br /> WORK PROP�SED e NEW CONSTR 8 ADD/AI.T � SIGN Q Q DEMO�tSH <br /> ,,.._. INSTALL REPAIR <br /> PR4POSED USE Q SFR Q COMM' �] OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME C] S7EEL Q <br /> DESCRIPTION OF WORK t%�I � � "� <br /> BUII.QIMG SiZE �—� SQ FOt?TAGE� HEIGHT C�� �� <br /> 1 <br /> QBUI�DING �� VAI.UAT10tV OF TQTAI.CONSTi2UCT10N <br /> � <br /> �ELECTRICAI. $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLU�BING $ <br /> � � <br /> �ME�HANICAL $ � VALUATION OF MECHANICAL INSTALLATION � I��� <br /> �]GASI Q ROOFING Q SPECIALTY � OTHER ���-�� � <br /> �� <br /> F�NISHED FLOOR ELEVATIONS FLOOD ZQNE AREA QYES NQ <br /> ') <br /> BUILDER C4NIPANY <br /> SIGNATIIRE REGISTERED Y/ N FEE CURRE� Y/N f <br /> I <br /> Address License# r� � ? <br /> ELEGTRICIAN GOMPANY <br /> SIGNATURE „ tte�isrEReo Y/ N FEE CURRE� Y/N <br /> Address ticense# � �� <br /> PLUMBER � . COMPANY <br /> StGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �icense# � � � � <br /> MECHANICAL Cp{HpqNy <br /> SlGNATURE REGISTERED Y/ N FEE CURR � Y/N <br /> Address License# r-���.���tp`�`ty � <br /> OTHER COMPANY <br /> SIGNATUi3E REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres�s� - License# �— � <br /> 4iiii�fi�t+ift <br /> RESIDENTiAL Attach(2}Plat Plans;(2}sets of Building Plans;(1)set af Energy Forms;R-O-W Permlt for new conshuction, <br /> � Minfmum ten(10}working days after submittai date. Required-onsite,Construction Plans,Stonnwater Ptans w!Silt Fence installed, <br /> �� Sanitary Facilttles&1 dumpster,Site Work Fermfk for subdivisEons/large proJects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy FoRns.R-O-W Permit for new constru+ction. <br /> �i Minimum ten(90}working days�after submittat date. Required ansi#e,Construction Plans,,Stormwater Plans w!Silt Fence installed, <br /> � Sanitary Faeil(ties 8 1 dumpster.Site Wark Permit for a0 new pra]ects.AI!cammerclal requtrements must meet comptiance <br /> 51GN PERMIT� Attach(2)sets of Engineered Plans. <br /> '*"PROPER'fY SURVEY required frar ali NEW construation. <br /> Dlrectlons: ( <br /> Fitl aut ap�ptication campletely. � <br /> Owner&Contraetor slgn back of applica�on,notarized <br /> If over$2500,a Notice of Commencement is required. {A!C upgrades over�7500) , <br /> '" Agent(fo�the contractor)or Power af Attomey(for the_owner)would be sameane with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING {Front of Application Onlyj ' , <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> �i ' , ., <br /> Driveways-Not over Counter if on publla roadways..needs ROW <br /> ,� <br /> �i <br /> �i <br /> i� <br /> m — <br />