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a�s-�sa-oazo City of Zephyrhills Permit Application Fa�c-813-780-0021 <br /> �I • Building Depattment <br /> Date Receivedi ��-%��ji Phone Contact for Perntitting � ��� Z - �-�` � <br /> � Owner's Nam��+ 4 �C� � Owner Phone Number - <br /> �Owner's Addrl ss �(07 �f�X C,�I� � � L,[ 3 y2, Owner Phone Number <br /> Fee Simpie Titteholder Name Owner Phone Number � � <br /> � <br /> �C � ' <br /> Fee 5imple Titleholder Address � ' <br /> JOB ADDRESS LOT# [� <br /> I <br /> SUSDIVIStON �— � PARCE�td# <br /> II (OBTAINED FRONO PROPERTY TAX NOTICE) <br /> WORK PROP�OSED e , NEW CONSTR 8 ADDIAI.T [� StGN Q Q DEMOCISH <br /> INSTALL i2EPAIR <br /> PROPQSED tJSE � SFR Q CQNtM � OTHER <br /> TYPE OF COI STRUCTION Q BLOCK - Q FRAME � STEEL Q <br /> e /ry�� �, f� �f� / � jj� � <br /> )C,DESCRIPTIQN OF WORK �� (,k.3�. �LL 'y� j�� C�'�GC 1^� � /�' S I <br /> / T ! <br /> BUICDING SiiZE SQ FOOTAGE� HEIGHT � " <br /> $�j�'d��� $ ,�� � VA�UATIOKi-OF TOl'AL CONSTRtlCTtON <br /> �ELECTRICAL $ �� �� ��.��--���_ A{VIP SERVIGE 0 PROGRESS ENERGY Q W.R.E.C. <br /> I <br /> �PLUMBING � � � <br /> �MECHANICAL $ VALUATlQN OF NiECNANICAL INSTALIATlGTN (,f`( " � <br /> � � <br /> D,G1j� � E2QOFING Q BPECiA�TY � OTHER <br /> FINISHED FL�OIOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> I - <br /> Bt31LL1ER "` COMPAttiIY '�(��`�Y""' �.�, <br /> �SIGNATURE 01/jC C V REGIS7ERED Y/ N FEE CURRE� Y/N <br /> � <br /> Address ,.- License# �_. � <br /> ELEG'1'F2ICIAIY �$� � C4MPANY <br /> SIGNATURE� � REGIBTERED Y/ N FEE CURRE� Y/N <br /> Address License# ' <br /> PLUMBER � COMPANY <br /> SIGNA7URE Re�isTEReo Y/ N FEE CURRE� Y/N <br /> , Addres License# �- � <br /> � <br /> NIECNANIC COMPANY <br /> SIGNATURE� REGISTERED Y/ N FEE CURRE� Y/N � <br /> Aiidress� License# � � <br /> ,s. <br /> Q7HEE2�, - i C4MPANY <br /> SIGNATURE I � REGISTERED Y/ N FEE CURREK Y/N <br /> Address� License# �— �� <br /> �� , <br /> RESIDENT(A�. Attach{2}.Ptat Ptans;(2}•sets of Buitding-Ptans;{1}set of Energy Forms;R-O-W Permit for new.construction, <br /> ;� .-. � Minimum,terr.(,10)working�days aftersubrriittal�date. Required onsite,Construc8on Plans,Stormwater Plans w/Silt Fence installed, <br /> �� Sanitary.Facilities.&1.dumpster;$ite Work Permit for sutidivisions/large.projects <br /> COi�MEi2ClAt. At#ach(2)comptete sets of 8u�tding Plans plus a[.ife Safety Page;(9)set of Energy Farms.R-O-W Permft for new construction. <br /> �i Minimum ten(10)working days after submittal date.,Required onsite,Constructian Plans,Stormwater Plans w/Silt Fence installed, <br /> � Sanitary Facilities&1 dumpSfer.Site Work Permit for aA new pro}ects.Atl cammercia!requirements must meet comptiance <br /> SiGN P�RMlii' Attach{2}sets of Engineered Ptans. , <br /> j ""PROPERTY SURVEY required for all NEW construction. <br /> , Directlons: �) � <br /> Fill out application completely. <br /> Owner B��Contraotor sign.back of apptEcation,notarized <br /> 1f over$2508,a Nafice of Commencement is required. (AIC upgrades over$7500) <br /> "" Agent(f�r'th`e contractor)or Power of Attomey{for tfie owner�would be someone with notarized letter from owr�er authorizing same <br /> OVER.THE GOUNTER PERM11?ING (capy of contract required) <br /> Reroofs if shir�gles Sewers Service Upgrades A/C Fences(Plat/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> � <br /> � <br /> t� -- - � <br />