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i � <br /> s�'3aso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ' • Building Department <br /> ( <br /> Date Recelv�d Phone Contact for Permitting _ i <br /> � /� (''' (� 2 q � <br /> Owner's ldame /►-� "'7�-� U ft/G�G✓ Owner Phone Number Q �cJ � �U�' / 7" � <br /> Owner'sAddress � � �� �� �^mD��G .Y - OwnerPhaneNumber � <br /> , — <br /> Fee Simple Titleholder Name �� � Owner Phane Number � � � <br /> Fee 8imple Titleholder Address <br /> .lOB ADDRESS �7 S. � �� �'UG'���� �� h f��l j ���" � �`LOT# �� <br /> St18DIVISION j�,¢'/l�'�� ���� =f- I �,a�c���o# ,��„2� t� �f� t���vv �'1:�.�� <br /> I (OBTAINED FROM PROPERTY TAX NOTICE) � <br /> WQRK PROPOSED e NEW COiVSTR 8 ADDIA�T [� SIGN Q Q DEMOLISH <br /> j� INSTALL 'REPAIR <br /> PROPQSED USE Q r SFR Q CQIIAM � QTHER <br /> TYPE OF CONSTRUCTION Q BLOCK - [� FRAME � STEEL Q � <br /> 4. / / / <br /> DESCRIPTIO I OF WORK G� / fi/.I�ti . O�✓��` � : <br /> BU1�.DING StZIE SQ FOOTAGE� HEiGHT � � <br /> ����Id��� r' � VAIL?ATION OF TOTA[.CQNSTRUCTEON <br /> L <br /> QEL�CTRICAL $ A�+IP SERVICE Q PR{}GRESS ENERGY Q W.R.E.C. . <br /> OPLUi BtNG $ <br /> QMEG�ANtCAL $ . VALUATI4N OF MECNANIGAL INSTALLATION ; <br /> ��jd�>� <br /> QGAS Q ROQFING � SPEClAE:TY �] t?THER <br /> FINISHED FLOOR ELEVATIONS �___� FLOOD ZONE AREA DYES NO � <br /> _ , r i <br /> i � <br /> , <br /> � j <br /> � � <br /> BUILDER � COMPAIdY ' <br /> SIGNATURE ' REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ; License# �� � <br /> ELECTRICtAN �i .• COMPAi�tY ` <br /> SIGNATURE i REGISTERED Y/ N . FEE CURRE� Y/N <br /> Address License# �— V � � <br /> P�UMBER; COMPANY <br /> SIGNATURE �REGISTERED Y�/ N FEE CURRE� Y/N <br /> Address " License#'���� � � <br /> I `� t rL .�l�ItN-t'1(Ir�' <br /> ' MECHANICAl. � COMPANY ,�t�" �i -� l�r <br /> SIGNATURE REGISTERED Y/ N " FEE CURRE� Y/N <br /> Address - , .�G� S f ,Z�(� (1"� !v j• ���' � �icens,e# ��� /Q �tT � /.� I . <br /> OTHER� �`` � ' = COMPANY <br /> SIGNATURE� ` REGISTERED ,.Y/.N . _ FEE CURRE�' . Y/N <br /> Address�- , License# �— � <br /> � <br /> RESIDENTIAt.,' 'I Af#ach{2}P16t Plans;`{2)s`ets of{Baililing=Plans,'{1)se#of'Energy,Farins;R 0-W Pe�n9t.for new.construction, <br /> , i, ; t , Minimum:ten°.(,10)working,iJays after'subrriittal.date. Required onsite��Constriictian Plans,Stoimwater.Plans w/Silt Fence installed, <br /> Sanftary Facilities,&�1•dumpster;Site:W.ork Permtt for.subdivisionsllarge projects <br /> -.._-COMMERClAl. � Attach�(2)'coniplete sets of Building PEans plus a t,ife Safety Page;{1}set of Energy Forms.-R-O-W Permit for new consfruc8an:--__.�,__�—__ <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Canstruction Plans,Stormwater Plans w/Silt Fence installed, <br /> ' Sanliary Facilities&1 dumpster,Site Work Permik fo�a!i new piojects.All comm�rciat requirements must mee#comp!lance <br /> ;�SlGN PERMIT � A#taoti(2}sets of;Engineered Ptans. ° , <br /> "`*PROPERTY SURVEY�equir.ed foc aII.NEW construction. <br /> ,:"Direction"s: � . _.,- , . <br /> Fill out appli�ation completely. <br /> Owner&Contractor sign back of appEication,notarized <br /> If over$2506,a Notice of Commencement is required. (AlC upgrades over$7500} <br /> " Agent(far the'c"ont�actor}or Power of Attomey(for the owner)would be someone with natarized letter from owner authorizing same <br /> w, OVER TtiE COUtdTER PERMITTING (copy of contrac#required} � <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> c - . <br /> Driveways-Not over Counter if an pubiic�roadways..needs ROW <br /> I <br /> i <br /> � —._ <br />