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s�a-�so-oaZo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> = Build'ing Department ��_ �. <br /> Date Recelved : +� _ <br /> �-'�� Phone Cantact far Permitting � <br /> Owner's Name �..�2 Owner Phone Number - T � <br /> Owner's Address �� S � Owner Phane Number �— � <br /> ' ���L � � <br /> Fee Simple Titiehotder Name Owner Phone Number <br /> �¢ <br /> Fee Siinple Titleholder Address <br /> JOB ADDRESS � c � � Q LOT# ��� <br /> SUBDIVlSION �� � PARCEL ID# � oZ� �} � <br /> (OBTAINED FROM PR PERTY TAX NOTICE) <br /> WQRK PRQPOSED NEW CONSTR ADDIAI.T � SIGN Q Q DEMOLISH <br /> � INSTALL � �REPAIR <br /> PRORQSED USE 'Q SFR Q COMM � QTHER <br /> TYPE OF CONSTRUCTION Q BLOCK • Q FRAME � STEEL Q <br /> � � <br /> DESCRIPTION OF WORK �P�fi <br /> BUI�DING SIZE �i � SQ FOOTAGE .�(� HEIGHT [—_____� <br /> �����'���� ���� VALUATION OF TOTAL CONSTt2UGT10N <br /> f <br /> DE�ECTf21CAL $ AMP SERVtCE 0 PROGRESB ENERGY Q W.R.E.G. <br /> �,,.._ � <br /> QPLUMBING $ <br /> C�� � i $3�1 <br /> I QMECHANlGAL $ VALUATIQN OF MECNANIGAL ENSTA�IATION ��t <br /> e 1 � <br /> OGAS f20QFlNG Q SPEClAI.TY � OTHER �� <br /> � � � <br /> FINISHED FLQOR ELEVATIONS FLOOD ZONE AREA �YES NO ��1 <br /> ti <br /> BUIlDER � COMPANY <br /> SIGNATURE REGI8TERED N FEE CUF2RE� /N , <br /> Address � � ��.�-"" ph. License#.�— � <br /> � <br /> , 'ELECTRICIAN - COMPANY ' <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address' License# � { � <br /> PLUMBER. COMPAi�tY <br /> SIGNATURE • REGISTERED Y°/ 'N'` ' FEE CURRE� Y/N <br /> Address � `"Cicense#'���— � <br /> MECNANICAL � C4MP�Wl' <br /> � SIGNATURE ' � REGISTerteo . �Y/-N FEE CURRE� Y/N <br /> � Add�ess-� , ' , � - <br /> I � , -Lic,ens,e#•.:� � <br /> �� :<::, , , - . ... <br /> ' - fJ?F#ER- "'. _ - COMi?ANY <br /> � SIGNATURE.. -� � - ' REGIS7ERED Y/.N.. FEE CURRE�' .,, r Y./N <br /> Addr�ss�, � - ' • License# �— � <br /> 'RESIDENT[ALt:, Attach�{2}:!'lofF2lans;-(2}:setsofBuilcling?P[ans;'(1)=setof'Energ}i'Forins;'R-0-W;Pe'rmit.for.new.construction,� <br /> • Minimum.#em,(a10),working;days'after."submittal`iiate. Required onsite,Cbnstructian Plans,Stormwater Plans w/Silt Fence installed, <br /> � .° :E� z,.. �9 P <br /> ' � Sanita,ry;;Facitities.&:l�.dumpster.;Site Wock:Permit for subd'ivisions/!a e rojects�:. - .,___ <br /> :GOMMERClAL. Attach{2)'complete sets of Builiiing Plans ptus a L.ife Safety Page;{9}set af Energy Farms.R-O-Utt Permit for new construction. <br /> " Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,Stormwater Plans w/Silt Fence ins#alled, <br /> Sanitary Faeflities&1 dumpster.Site Wark,Permit for all new proJects.Ali commercia!requirements must meet compliance <br /> ;.�,SiGN PERMiT Attach(2)sets of,Engineered Ptans.�� � <br /> � � '"**PROPERTY SURVEY required for.all.NEW,canstructian. <br /> Directtons: �;•-:t=-- - . <br /> - Fill out application completely. <br /> � � Ovirner&Gontraator sign.back of application,notarized <br /> - . If over$2500;a Notice af Commencement is required. (A/G upgrades over$750d) <br /> "' Agent{for'fhe cont�actor)'or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> ,.;OVER.7HE COUNTER;PERMiTTING. , (copy of cantraet required). <br /> �; Reroofs if shingles Sewers ', Service.Upgrades-A/C„ Fences(Plat/Survey/Foatage) <br /> _. . . - "(I.. .. ., li <br /> Driveways-Not over Counter if on public�roadways.:need's,�ROW;. � ' � <br /> ' „ . ,. , ;; <br /> , � --_. ! <br /> , - - <br />