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813-7ao-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ' J ° Building Department <br /> Date Receive� Phon�,Contact for Pe►mittin <br /> i ��/ / <br /> Owner's Na le � � �" ( �h�� Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> Fee Simple T3tleholder Name Owoer Phone Nlumber <br /> Fee Simple Titleholder Address ^ <br /> JOB ADDRE$S ��%3 p�� � LOT# � <br /> SUBDIVISIO PARCELID# C�a'2((J'� ��0�1�C�lpOpp ��`jp 2C7 <br /> (OBTAINED FROM PROPERTX TAX NOTICE) <br />, WORK PROPOSED , .B • NEW CONSTR ADD/ALT Q SIGN � Q DEMOLISH <br /> INSTALL - REPAIR <br /> PROPOSED�USE -Q SFR COMM Q OTHER <br /> TYPE OF CO STitUCTION - Q BLOCK " FRAME � � STEEL Q <br /> DESCRIPTIa OF WORK 'lY1 J JU � �2i�U1 C`e <br /> BUILDING SI�E � SQ FOOTAGE� _ HEIGHT <br /> QBUILDING $ VALUATIONpOF'TOTAL CONSl'RUCTION <br /> ELECTRICAL $ � AMP SERVICE �SL� PROGRESS ENERGY W.R.E.C. <br /> ��o� � , o <br /> OPLUMBIIVG $ ' <br /> MECHANICAL $ VALUATION OF'MECHANICAL INSTALLATI N ���� <br /> CI O -�T � <br /> QGAS Q ROOFING .Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER Cp(ypqNy= <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Llcense# <br /> ELECTRICIAN_ �,�,� ' COMPANY � P 0-'� �' <br /> SIGNATURE j ����/�"1 ' REGISTERED Y/ N FEE CURRE�' <br /> Y/• <br /> Address License#_ �l� UU� �- <br /> PLUMBEPt ' COAAPAPIY <br />� SIGNATURE ' REGISTERED Y./,.N FEECURRE� ' Y•/N. <br /> Addre�s License# . <br /> MECHANIC ' COfNPANY <br /> SIGNATIDRE � � � REGISTERED Y,./ N FEECURRE� Y,/•N <br /> Address' � � � � License# <br /> OTWER � `;COMPANY_ � � <br /> SIGNATURE' �• ' ' ' ' REGISTERED Y/ N... FEE CURRE� Y/N � <br /> Addre�s ' - � ' ' � ' � License# � <br /> RE31D@WTIAL:: . Attach'(2),Ploti Pla�s;;.(2)sefs of�Bullding'Plans;`(1)sef of'Energy�Fortns;�R-O-W Permit far new construction, <br /> Min(mum:ten,_(d0):working,days,after submiftal`date::Requlred onsite;:Consfiucdon-Rlans;Stortnwater Plans w/SIIt Fence installed, <br /> Sanitary FaciliNes-&;1,dumpster,�Slte•Work Pertnit for subdidislons/!arge projects <br /> CORAAAERCIRI. Attach(3J complete'sefs of Buildfng"Plan's plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new coqstruction. <br /> Mfnimum ten(10)vuoricing days'after submittal date. Required onsite,ConsUuction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliUes 8 1 dumpster.Site Work Pertnit for all new;proje'cfs:All commerctal requlrements.must meet compliance • <br /> SIGN PEI2RAIT Attacfi"(2)sets ofEngineer.ed-Plans.. � - � <br /> ""'PROPERTY SURVEY required for all NEW construction. <br /> Directlons: � ' <br /> Fill out appiicadon wmpletely. <br /> Owner&Conhactor slgn back of applfcatlon,notarized <br /> If ovar�2 00,a Notice of Commencement is requlr�d. (AIC upgrades over�T500j <br /> " Agent(for the contractor)or Powe�of Attartiey'(for the owner)would be someone with notarized letter from owner authorizing same <br /> DVER THE C9UNTER PERMITTING - �(Front of ApplicaUon Only)- : <br /> Reroofs If shingles Sewers Servjce Upgrades i4'/C�4' ��Fences(PIoUSurvey/Footage) <br /> Drivewa i-Not over Counter if an public roadways..needs ROW� �, ;� , , <br /> �: _ ,. � ..., .- �.-.., . � . <br /> � <br />