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. , a��-�saooso City of Zephyrhills Permit Application Fa�c-a»-�ao-oosi <br /> aurding Deparm,em <br /> Date Received <br /> Phone CaMad tw Permittin °� (�� <br /> Owne�'s Name �C .�/1 �/'C3�� Ormer Phone Nwnher <br /> Owner":Addre� ��� 1 �'( 1 1� . Owner Phone Nunber <br /> Fee Simple Titleholder Name Oiwner Phone Nunber <br /> Fee Simple Titlehdder Address <br /> JOB ADDRESS � �Y I� LOT X 1�7 � <br /> SUBDMSION �� PARCEL IDiM�l^ �- � ( <br /> (OSTNNED F7lOY PROPERTV TAIf tWTICE) <br /> W���OP�� � NEW[ONSTR ADDlALT � SIGN Q � DEMOLISH <br /> INSTALL e REPAIR <br /> PROPOSED USE SFR Q COMM Q OTHER <br /> TYPE OF CONSiRUCT10N Q BLOCK Q FRAME � STEEI Q <br /> oescraPnoN oF worac �'e ���`� SI'h+'rt �G S 1.,�-StYL �Gt l'1'�-$ �. � �- <br /> BUM.DING SI� SQ FOOTAGE�7G_kL�CJ HEN3HT � <br /> QBUILDING S ��, %; O VALUATION OF TOTAL CONSTRUCTION <br /> V <br /> QELECTRICAL a AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ � 1I,/ <br /> QMECHANICAL $ VALUATION OF MECHANICAL WSTALLATION �� V <br /> �G� Q ROOFING Q SPEqALTY Q OTHER �/ ���� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QVES NO <br /> BUILDER CONPANY <br /> SIGNATURE rtEC,�s�r�o V! N �E cukaE� Y/N <br /> Address <br /> License# <br /> ELECiRICIAN COMPANY <br /> SIGNATU(� REGISTERED Y/ N �e c�n Y/N <br /> Addresa <br /> License it -� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y! N �E curt�n Y/N <br /> Address <br /> License�t <br /> NECHANICAL C�Pµ�, � <br /> SIGNATURE REGISTERED Y 1 N FEE CURRE� Y!N <br /> Address <br /> License# <br /> SI NATURE CONPANY \ V1��x V _ .�`�r �n-1 l 1 K_ I <br /> r�c,�s�aeo Y N r�E cuw�� Y!N <br /> �� ' " 4 � Licerse# C � <br /> IIIIIIIIIIIIIIIIIIIIt1111111111 � 11111111111111111111111111111111111 <br /> �S���IK Attach(2)Plot Plar�:(21 sets d Building Plans;(1)set of Er�rgy Forms;R�W Permit far new conshudion, <br /> Minsnwn ten(10)working days after su6mittal date. Required onsite,Constniction Plans,Stormwater Plans w/Sik Fence installed, <br /> Sanitary FaciFties&1 dumpsler,Site Work Permit for suhd'nrisionsAary�pr�j� <br /> COMMERCIAL Attarh(3)canplete sets of Building Py�plus a Life Safery Page;(1)set of Energy Forms.R-O-W Permrt for new mnstruction. <br /> Minimum ten�10)working days a/tersubrrMtal date. Requined onsite,Cmstru�Uon plans,Stortnwater Plans w!SYI Fence instaNed, <br /> Sanitary Faciities&1 dumpster.Site Work Permil fw�I new pojecLS.qll oommrltyat requirements musl meet compiance <br /> SI(iN PERYfT qtla�h(2)sets d Engheered Plans. <br /> ""PROPERTY SURVEY required for�NEW construqian. <br /> Direcdw�s: <br /> Fi1 aut appNcation completely. <br /> Owner&Contractor sign back d application,notarized <br /> M over 52500,a Notla of GoMmd�cament ts requlred. (AIC upgradea over S7i00) <br /> „ qgent(1or the contraaar)nr Povrer of Attomey(for tlie ow�er)would be sameone wNh ndarized lener from owner authorizing same <br /> PERA/fTTMG (Frant d Applicaba�O^�Y) <br /> Reroo/s if sMngles - Searers Service Upgrades A/C Fences(PbUSurvey/Footage) <br /> aYb�Jot over Countei if on Pudic roa�ways..needs ROW <br />