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s�a•7 0-002o City of Zephyrhills Permit Application Fax 813-780-0021 <br /> • Building Department <br /> Date Req3rr� phone Gontact tor Permitting — <br /> Owner's Nam r(�W�. G/(.!�'��' Owner Phone Number <br /> Owner's Addr ss �D�v�-� ���T��� Owner Phone Number � � <br /> Fee Simple Ti leholder Name �— � Owner Phone Number �� � <br /> Fee Simple Ti leholder Address <br /> JOB ADDRES �t S�� ��/`fT�1��� LOT# �� <br /> su���v�s�os� .�i`.0�lG:,lL �1�t-f1� � PaacE��a# ��' —�'-1`-�fi.�. ��—l1 p�JQ(�--Pd7�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> W4RK PROP SED e , NEW CONSTR 8 ADDIA�T C� SIGN Q Q DEM0�18H <br /> INSTAI.L REPAIR <br /> FROPOSED. SE Q 8FR Q COMM �� 'OTHER <br /> TYPE OF CQ STRUGTION � BLOCK • Q FRAME � STEEL Q <br /> Y ,j1 �/ ,(_f <br /> DESCRIPTiQ OF WORK �� /L..��'� G�It f"'/ �� � �'Ll���'�-f <br /> BUEGDING St I E �— � SQ FOOTAGE HElGHT �` � <br /> � <br /> QBt31 DtNC � ���0 VALUATION'OFTQTALCONSTRUCTION <br /> QE� CTRIGAL $ AlV2P SERVtCE 0 PROGRESS ENERGY Q W.R.E.G. <br /> QPL MB1NG � ._. � � � � �.� <br /> �ME HANICAL $ � VALUATION QF MEGHANICAL INSTALLATIQN <br /> ��r <br /> QGA �RQOFING [� SPEClAl.TY � OTHER �� ( � <br /> FINISHED FL OR ELEVATIONS ��� FLOOD ZONE AREA DYES NO <br /> BUILDEE2 CONIPA3�IY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres License# �� � <br /> ELEGTRtCI COMPANY <br /> SIGIdATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres License# �— s � <br /> PlUlVIBER. CONtPANY� <br /> SIGNATURE REGISTERED Y•/ N FEE CURRE� � Y/N <br /> � Addres y License# � � <br /> i1+lECHANEC CQMPANY <br /> SIGNA7'URE� REGISTERED Y/ N FEE CURRE� Y/N <br /> Aiddres " License# � � <br /> OTNER t ;. �Ji-7 � COM P1�1�lY G/f'�tta 11� !C C:l�-`I�� <br /> SIGNATURE � '� REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres .. � � h.: �3 t0.� ���""�i14 License# ��- 0��,l7�y'j � <br /> :RESIDENTI _,. Attach.{2}:Plot Pians;{2},s'ets of Builclang�P[ans;{1)'set�of EnergyFoizns;R-Q-Vtt Permlt far new,constnaction, <br /> -���•. �Minimum�ten�.(;10)wo�kingldays after.submitta6date. Required onsite;Con'struction Plans,Stormwater Plans w/Silt Fence installed, <br /> � Sanita,ry.;Facilities&;;1:.dumpstec;Site. .W.ork�Perr»it for.subd'ivisionsllarge projects: � <br /> t-COMMERCI Attach{2}comp�e�e"sets af Buittiing P�ans plus a�Life Safety Page;{1)set of Energy Forms.R-O-W PeRnit for new construction. <br /> � � Minimum ten(10)working days after submittal date. Required onsite,Constructian Plans,Stormwater Plans w/Silt Fence ins#alled, <br /> Sanitary Facilities&1 dumpster.Site Work Permit fo�a!!new proJects.Ail cammercial requErements must meet comptlance. <br /> SIGN PERMf Rttaicti{2}se#s of:Engineered Plans. �. <br /> '""`*PROPERTY SGRVEY required for all NEW constructian. <br /> Dlrec#tons: s.• :-- , <br /> Fill,out a plication completely. <br /> Owner CoMcactor sfgn.back of apptication,notar�zed <br /> • iE over$ 500,a Notice af Commencement is required. (AIC upgrades over$75d0) <br /> "" Agent(fqr the=contractor)or Power of'Attamey(for the owner)would be someone with notarized letter ftam owner authorizing same <br /> OVER THE C'OUNTER=P,ERMIITING {copy of contract required} <br /> � Reroofs if shi�gles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Drivew ys-Not over Counter if on pub(ic roadways..needs ROW <br />