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813-780-0020 City of Zephyrhlills Permit Application Fax-813-780-0021 <br /> Buildi�g Department <br /> /��=.� <br /> D�te EteceiNecB �i <br /> �o � Phone Contact or Permittin Z! ��� -- �j��� <br /> Ornrner's R1ame 2 LD �- Owrner Phone Mumber <br /> Owmer's Address �(� � �� ' � Owmer Phone Rlumber <br /> Fee Sirviple Titleholder Mame Ovener Phone idumber <br /> Fee Simple Titlehoider Address <br /> .DOB ADDRIESS S� D � , � � d'1�e�l Z /��-l ) LOT# �_� <br /> susni�osio� �nrtc� s�� 1 1 �zL �2� bvr c�/ t �(�csv �(�,21U <br /> (OBTAINED FROM pROPERTY TAX NOTICE) <br /> HNORFC PROPOSED B NEW CONSTR e ADD/A �5c� SIGM Q Q DEMOLISH <br /> INSTALL REPAI T <br /> P620POSED USE Q SFR Q COMM � OTHER <br /> 1VPE OF CORlSYRUCTlOM Q BLOCK Q FRAME � STEEL 0 <br /> DE�CRS�TIOM OF MlOFt�C �j� �� wi���s 5�Z� sc2� F�. 1��s, 7 <br /> BUILDIfdG SIZE SQ FOOTAGE HEIGHT <br /> �BUILDING $ / � VALUATION OF TOTAL CONSTRUCTIORI <br /> QELECTRICAL $ AMP SERVI E 0 PROGRESS ENERGY 0 W.R.E.C. <br /> OPLUMBING $ \���� <br /> � � ��--�1�-, <br /> �MECHAfVICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> QGAS ROOFIfVG SPECI LTY OTHER (\a� <br /> 0 0 0 ���� <br /> FIiVISHED FLOOR ELEVATIOfVS FLOOD ZONE AREA DYES fV0 ���1 ✓ <br /> sui�n�R , r� connPAr�Y � .�. �.��� � �7 <br /> SIGIdA1YURE ' •� RE¢ISTERED Y/ N FEE CURR � Y/N <br /> i <br /> �►ddress U�iG�/)s � / License# � G/S��/�75 <br /> Ed.ECTRICIAM � {y�pq�y <br /> SIGidA►TURE RE ISTERED Y/ N FEE CURRE� Y/M <br /> Address License# <br /> PLUAABER COIMIP�►IdV <br /> SIGRIE►TUPZE REC�ISTERED Y/ N FEE CURRE� Y/N <br /> � <br /> �lddress License# <br /> i1flECHAMICAL Cq RAPAfdV <br /> SIGRIATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> � <br /> Address License# <br /> OTHER C MPAtdY <br /> SIGMATURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> 61dc9ress License# <br /> EtESEDEIdTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set f Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. R quired onsite,Construction Plans,Stormwater Plans w/Silt Fenoe installed, <br /> Sanitary Facllities 8 1 dumpster;Site Work Permit for s bdivisfons/large projects <br /> COiIARAERCIAL Attach(3)complete sets of Building Plans plus a Life S fety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. R quired onsite,Construction Plans,Stormwater Pians w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Perm(t for II new projects.AII commercial requirements must meet compliance <br /> SIGfd PERIIAIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construFtfon. <br /> Directlons: <br /> Fill out applfcation completely. <br /> Owner&Contractor sign back of application,nota�ized <br /> If over 5�500,a fdotice of Commencement ls required. (A/C upg ades over;7300) <br /> •" Agent(for the contractor)or Power of Attomey(for the owner)would e someone with notarized letter from owner authorizing same <br /> 01/ER THE COUIdTER PERIVIITTIfdG' (Front of Application Only) - <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage) <br /> , , , <br />' Driveways-Not over Counter if on public roadways..needs ROW ' ' � <br />