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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> �ate Fteceiaed ��3 ��7� - ���� <br /> Phone Contact fqr Permitting - <br /> Or�rner°s fdame �/��� �/Pi�� Ourner Phone Mumber v��.J /��' d/. �� <br /> �rnrner's Address Owmer Phone fdumber <br /> Eee Sirnple Titleholder R1ame Owner Phone idumber <br /> I <br /> Fee Simple Titleholder Address <br /> � <br /> JO�6►DDRESS �D D�!/ ��GLDI�lZ�/2V /�E7C, �////�C7 � ��4 . ���� LOY# � <br /> sue�idisiob �eeRC��.io#D� �lc. �/__ d'D%� D�G� D�LvL -- - <br /> (OBTAINED FROM PROPERTY TAX IdOTICE) <br /> WOR6C PROPOSE� NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> B INSTALL RERAIR <br /> �ROPOSED U5E Q SFR Q� COMM 0 OTHER <br /> �PE OF COMSTRUCTIOfd Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTIOId OF WORK �,(,, � �,lV �— j�2� � rp � e� <br /> � <br /> BUIILDIfdG 51ZE SQ FOOTAGE� HEIGF9T <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.0 <br /> OPLUMBING $ ,�� <br /> � <br /> QMECHANICAL $ ���C7' �� VALUATION OF MECHANICAL INSTALLATIOtV � `� <br /> / <br /> QGAS Q ROOFING Q SPECI LTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES MO <br /> BUILDER CO�kIIPARIY <br /> SIGfd�eTURE REC�ISTERED Y/ N FEE CURRE� Y/IV <br /> i <br /> �4ddress I License# <br /> EL.EC�'RICIAN CO�AlIPAtdY <br /> SIGMEIYURE REGISTERED Y/ N FEE CURRE� Y/f�l <br /> � <br /> Alddress License# <br /> PLURfl�ER CqMPAtdY <br /> SIGRIATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> � <br /> Elddress I License# <br /> � � t���n�� <br /> AfIECH411dICAl. ��� C IVIPAfdY Dgi�i� �l'l} F}- 2CS1`7'S <br /> SIGtdATURE REGISTERED Y/ N F E CURRE� Y/IV <br /> i <br /> Acldress ��'�� ��L' �•/ll�� 33 � License# �/Y�—U '�J�'J� `7�d <br /> � <br /> o�H�r� c��nP�,r�v <br /> SIGM9►TURE RE ISTERED Y/ N FEE CURRE� Y/N <br /> �lddress License# <br /> RESIDE�ITIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)seti of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. f�equired onsite,Construction Plans,Stormwater Pians w/Silt Fence installed, <br /> Sanitary Facllities 8�1 dumpster;Site Work Permit for Subdivisions/large projects <br /> COMAAERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permft for all new projects.All commercial requirements must meet compliance <br /> SIGId PERINIIT Attach(2)sets of Engineered Plans. <br /> """PROPERTY SURVEY required for all NEW construction. <br /> Directlons: <br /> Fill out application completely. <br /> Ovmer 8 Contractor sign back of application,notarized <br /> Ef over g2500,a Ido4ice of Commencement is required. (AIC upg�ades oeer;7500) <br /> "" Agent(for the contractor)or Power of Attomey(for the owner)would�e someone with notarized letter from owner-authorizing•same �,,. ; <br /> ONER THE COUNTER PERAAITTIMG (Front of Application Oniy) „ � � _ . . ' - ' <br /> Reroofs if shingles Sewers Service Upgrades A/C Fence (PIot/Survey/Footage) , � ' <br /> , - , , � <br /> Drivevways-Not over Counter if on public roadways..needs ROW °� ° �" ' °" `"r""`"°T <br />