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Per��nit�Application Page_1 pdf http.//www ci.zephyrhills.fl us/files/Building_DepUPermit_Applica.. <br /> — 313-780-002� City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Bwlding Department \1 <br /> Date Received �" ,l/ <br /> ' Phone CorrtaM for Permitting � } -- � ,\�1�� " <br /> � � iir � � � � ir � � ��� U� <br /> Owner's Name ur�.1� �aZa��.(� l7(JLY �1�50r1 Owner Phone Number ��J' '1�� <br /> Owner's Address �p� 1 1��� �', � rhills Owner Phone Number $�'qy#_�-sa y �l <br /> Fee Simple lltleholder Name � � Owner Phone Number C— <br /> Fee Simple lltleholder Address <br /> J08 ADDRESS T� h �� LOT N � <br /> SUBDIVISION � PARCH.IDA � '�2ty'� Z��W �(�Q'�( <br /> IOBTAMIED FROM PROPERIY TAX NOTICE! <br /> WORKPROPOSED B '�ENlCONSTR� ADDlALT� Q SIGN Q � DEMOLISH <br /> INSTALL <br /> PROPOSED USE � SFR � COMM � OTHER <br /> NPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPl10N OF WORK Ap ( • �� QU nD GLU <br /> BUILDING SIZE �—� SO FOOTAGE� HEIGHT <br /> �BUILDING $ /Gb D VALUATION OFTOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W R E C <br /> �PLUMBING $ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �` ���� <br /> �GAS Q ROOFING [� SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIOPIS �� FLOODZONE AREA �YES NO <br /> BUILDER � COMPANY �G�NFIQ 'y� <br /> SIGNATURE REOISTERED Y I N FEE CURRE� Y 1 N � T <br /> J Address License# �— <br /> _...-.,.,.,. � <br /> ELECTPoCIAN � ,(� ,(��('� COMPANY �— �`v � <br /> SIGNATURE � ' �,1 IT�L�� '� � REGISTERED Y I N fEE CURREP Y J N <br />.�r y Address License# �— � <br /> � ��1°t� PLUMBER COMPANY / �� <br /> SIGNAIIJRE REOISTERED Y I N FEE CURREP Y 1 N / ���� <br /> ( <br /> Address License# <br /> '�t;�?'l� <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# <br /> OTHER � � COMPANY �— <br /> SIGNATURE REGISTERED Y J N FEE CURRE� Y 1 N <br /> Addross License# �—�� <br /> IIIIIIIIIIIIIIl1I111I111i1111111ii1111ililll111111i1ltI1111II1f1Ili <br /> RESIDENTIAL At[ach{2)Plot Plans,(2)sets of Butld�ng Plans,(1)set of Energy Forms,R-O-W Permit for new construction, <br /> Minimum ten(10}wor4�ng da�s after submittal date Required onsite,Construction Plans,Starmwater Plans w!Sdt Fence installed, <br /> Sanitary FacdRies&1 dumpster,Site Work Permrt for subdiwsionsllarge pro�ects <br /> COMMERCIAL A[tach(3}complete se[s of Building Plans plus a Life Safery Page,(1�set of Energy Forms R-O-W PermR for ne�r construction <br /> Minimum ten(10)workfng da�rs after submittal date Required onsrte,Cons[ruction Plans Stormwater Plans w!Silt Fence installed, <br /> Sanrtary Facdities&1 dumpster Srte Work PermR for all new pro�ects All commernal requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans <br /> "**PROPERTY SURVEY required for all NEVY construchon <br /> Direcdons: � � � � + � i � �a � � <br /> Fill out applicaUOn completey <br /> Owner&Contractor sign back of apph[ation,notar2ed <br /> If over 52500,a Notice of Commencement is required. (AtC upgrades over 57500) <br /> "" Agent�for the contrector)or Power of Attorney(for the owner)would be someone with notanzed letter from owner au[honzing same <br /> OVER THE COUNIER PERMITfING (Front of Apphcation Only) <br /> Reroofs rf shingles Sewers Service Upgrades A1C Fences(PIoUSurveylFootageJ <br /> 1 of 1 nriv�wave_Nnt rn�ar('nnntor rf nn niihlir mariwavc npqric R(lW 3/13/2013 1:13 PM <br />