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ais-�ao-ooao City af Zephyrhills Permit Application Fax-813-780-0021 <br /> . � Buflding Department <br /> �ate Eteceived Phane Cantact for F�rr»ittin -- <br /> '"tTi"'t`� <br /> . <br /> Owner's N�me t t,� Ov�ner Phon�fliumber ' <br /> Qwner's Address � �•� Owner Phone Plumber � � <br /> Fee Simple Titleholder Wame �, ' � Owner Phane Number � <br /> Fee Simple Titieholder Addr�ss <br /> JOB ADDRESS � � �:S LOT# ��_� <br /> SLlBDIVISIOtd � � P/�RCEL ID# <br /> (OBTAINED FROM PROPER7Y TAX NOTICE) <br /> W9RFC Pi�OPOSED NEW CONSTR ADi7/ALT � SiGN.. , Q ; [� DEMOLiSH <br /> e INS7ALL � REPAIR <br /> PftOPOS6D ClSE Q S�Ft • � CC3MM ,� OTHER <br /> 1'YPE OF CONSTRUCTIOM Q BLOCK' Q FRAME � STEEL Q <br /> T ' <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE ��� SQ FOO7AGE���� HEIGH7 �____��� <br /> �Btl1Lt31NG (9Lc�, �/`� ��� VALUATIOP�OF TOTA�.CONSTRUGTIOIV <br /> L �� <br /> �JELEGTRiG�L � � flMP SERViCE Q PROGR€SS€NERGY Q W.R.E.C. <br /> [�PLUMBING i—.� � <br /> QMECHANICAL ($ '���� VALUATIO{V t?F MECNA�IICAL iNSTALLATION <br /> �� <br /> QGAS � FtOOF1tdG Q SPECtAI.'t'Y � OTHEF2' <br /> � <br /> FWtSHED FLOOR ELEVATt'ONS ��+----� FL�OD ZC?NE AREA �`(E5 N� <br /> y�..�- a . . . . . . . � . . . ._. . <br /> BUILDER ���, „ COMPANY ( � � . <br /> SIGNATURE � �1,;�� REGISTERED Y/ N, FEE CURRE� Y/N <br /> I Address ' License# � � <br /> ELECTRICIAPI COMPAPIY <br /> SIGPIATU02E REG(BTERED Y/ I� FEE CURRE� Y/lV <br /> Address License# � � I <br /> PLUMF�ER CONiPA�dY � <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y!N <br /> �ddre�s � Licens�# �� � <br /> N'fECHAAIICAL COMPANY � � � <br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N. ' � <br /> I Addre�s License# � � <br /> OTHER - COMPAfdY <br /> SIGNATURE REGISTERED Y/ fV FEE CURRE� Y/N <br /> .---. _ <br /> Address License# � � <br /> t911 ! ! 1 ! liill � llttlfllE-i11ElitlA ! lltli111 ! l1111111 # I ! ! lEiilill ! ! i ! � <br /> RESiDEi�TiAt. Attach{2)Piot Pians;(2}sets oFBuiiding Pians;(1}set of Energy Forms;R-O-W Permit far new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Siit Fence-installed, <br /> Sanitary Facilities&1 dumpster;SiEa.Work Permtt far subdivis'sonslEsrge projects <br /> -CO�iMI�RCfAI. Attach(2)compiete sets of Buiiding Plans plus a Life Safery Page;(1)set of Energy Forms,R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date: Required onsite,Constructiqn Plans,Stormuuater Plans w/Silt Fence installed, <br /> Sanitary�acilit�es&1 dumpster.Site Work PeaYsit#or a11 new projects.Ail commercial requicements snust snset campliance <br /> SIG�d PERMIfi Attach(�)sets bf Engineered Pians. <br /> **""PROPERTY SURVEY required for all IdEW cpnstruckion. <br /> Directlons: <br /> Fill out application campletely. . . <br /> t}wner&Contractar sign back of applicatEon,natarized <br /> !f aver�2500,a Notice o�Commencemen4 Is required. (AfC upgrade�over$7500� - <br /> *' Agent(far the canEractar)or Power of Attarney{fot ihe awnsr}would be someone uvEth notarized lettsr from owner authorizing same <br /> � OVER THE CQUNTER PERMITTING (copy of contract required) <br /> ' Reroafs if shingies Sewers �ervice Upgrades A!C ��n�es(PfaU�utv�yt�oat�ge) <br /> 'I Drivewaye-No1 aver Courrter Sf an publir.7oadwaye..nea+��4iOtPd <br />