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813-7�-�� City ot Zephyrhills Permit Application Fmc-813-780.0021 <br /> BuNdlnp DepaAmenl <br /> Date R�cNwd phon�Contaet fw P�rmltNn <br /> Owners Name Owner Phons Numbs► <br /> Ownere Address Ownsr Phons Number � <br /> Fee Simpla Titlehdder Nams � � Owner Phone Numb�r <br /> Fea Slmple Tilleholdar Addrsas <br /> JOB ADDRESS LOTM � <br /> SUBDIVISION PARCEL IDR <br /> 1oer�En FrtoM vROVenn TNC Honcel <br /> WORK PROPOSEO B nEw Cav57R e ADD/AlT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q fRAME Q STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE 30 FOOTAGE� HEIGHT � <br /> �BUILDING i VALUATION OF 70TAL CONSTRUCTION <br /> QELECTRICAL �� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �UMBING s I OD V <br /> QMECHANICAL S VALWTION Of MECHANICAL INSTALLATION <br /> �GAS Q ROOFING O SPECIA�TY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE rtEdsrertEO Y/N �ecuwea V/N <br /> Addrese Lkense tk <br /> ELECTRICIAN COMPANY � <br /> SIGNATURE aeois7eneo Y/ N r�E cuna� Y/N <br /> Addrass ��Se* �--� <br /> PLUMBER COMPANY (I� 1'I RWi`r�,ri�►{N PLU�Y1�iN�_ <br /> SIGNATURE / ► REOISTERED ! N �curt�n Y/N <br /> Address � ��� � l.�H(L.Y {tU ,LKl(.S`.l.RNv�Y L 3� C I Lkensa� � ���C'���o�i��, <br /> MECHANICAL � COMPANY <br /> SIGNATUIRE RECSISiHtEO V! N �e cu� Y/N <br /> Addrlss l.icenae A <br /> OTHER COINpANV -� <br /> SIGNATURE Recisr�o Y/ N �e c�En Y/N <br /> Addresa <br /> License* -� <br /> 111111111111111111111111lIIIt11111111111111111111111111111111111111 <br /> RESIDENTIAL Atlach(2)Plot Plam;(2)aela of BuBdirq Plans;(1)ael of Enerpy Forms;R-O-W Permlt(or new construcllan, <br /> Mlnimum Im(10)workinp days atter submlttal Aate. ReQuFed onsRe,Conatructlan Plana,Stormwater Plans w/Silt Fence installed, <br /> Sanftary Fedfllks d 7 dumpaler;Slle Wak Pertnil lor subdivisionaAarqe projeda <br /> COMMERCIAL Attach(3)complele sets ot Buildmp Plana plua a lHe Safety Pape;(1)ael o!Enarpy Fams.R-O-W Permit for new conslructbn. <br /> Minimum ten(10)workinp days afler submHtal dale. Required onsile,Canstructlo�Plans,Slormwater Plans wf Sill Fence Inslalled, <br /> SanRary FaeNlNes 8 1 dumpater SMe Work Permit irn eA new proJecta.All commercial requiremenls mual meel compliance <br /> SIGN PERMIT Altach(2)sels of EnpNiaered Plans. <br /> "'•PROPERTY SURVEY requlred for all NEW construclfon. <br /> Dfreatfonn:• <br /> 1 1 � 1 { � <br /> Fip ou�appication complelNy. <br /> Owner 8 Contraclar sfgn back of epplicetlon,nolarized <br /> If ove�32500,a Notice o/Comm�nc�mant is roqulr�d. (A/C upgnd�a over j7500) <br /> " Apent{for Ihe contracla)w Power of Attomey(for lhe owner)would be someo�e with nolarized letler(rom owner authaizing aame <br /> OVER THE COUNTER PERMITTING (Fronl o(Application Ony) <br /> Reroofs H shingles Sewers Service Upgrades A/C Fences(Pbt/SurveylFOOtage) <br /> Drivaways-Nol over Counter II on pub6c roaCways..neetls ROW <br />