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813-780-0020 City af Zephyrhills Permit Application Fax-813-780-Op21 <br /> Buflding Department - <br /> Date Recelved _'�,;2"�." phflfie.Cantast or PermtttFn - ` . <br /> Qwner"a Name t,.� ��. �UL-G-L'v�� Owner Phona Number � t J� ! �S� (�� <br /> Owne�'s Address � /��4� �/�IZv� �L-� Owner Phane Number 0 �3 r �p� '" cp �� <br /> Fee Slm le Tltleholder Name Owner Phane Number � � �'���" ��C L'� <br /> P � . � �� <br /> I <br /> Fee Slmple Titleholder Address <br /> ,t f <br /> JOB ACIDRES8 ���`7� �X��� ���% LOT# <br /> SUBDIVISION c� �-���-=�-�� h�� PARCEL ID# <br /> (OBTAINBQ FROM PROPERTY TAX NOTICE) <br /> y WORFf PROPOSED NEW CONSTR ADD/A T � S1GN Q Q DEMOI.ISH <br /> e INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR [� COMM� Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK [[� FRAME� ' � STEEL Q <br /> DESCttIPTIONOFWORK �G�SC(LL�l�.�►J Q1' '�t�Co�)N� �L (ZX Z3r� t+ <br /> BUILDtNG SIZE �� � SQ FOOTAGE�� HEIGHT �� <br /> �B���d��� � `'��j (�O(�j VALUA710N QF TOTAL CONSTRUGTION <br /> QE{.ECTRICA� ($ � AMP SER CE [� PRUGRESS ENERGY Q W.R.E.C. <br /> � <br /> QPLtiMBING {$i`� �� <br /> � �p � <br /> QMECHANiCAI $ VAlUA7tQN QF MECHANICA�.tHSTALIATI � `�`i�- �"'�' 't " <br /> O� O R�QFING Q SPECI TY � OTHER t "�� ��� <br /> FIIVISHED FLOOR ELEVATIONS FLOO D ZONE AREA QYES NO � P���h� <br /> � <br /> � <br /> BUILDER �, ' C�MPANY ��G�"t t' C7n.�1J G'''� <br /> SIGNATURE REGI37ERED Y/ N FEE CURRE� Y/N <br /> Address Llcense# �� � <br /> � ELECTRtC1AN . � COMPANY <br /> SIGNATURE REGIS7ERED Y/ N PEE CURRE� Y/N <br /> Address � License# ��_ � <br /> PLUMSER �(� ��{�pq�( <br /> SIGNATURE �"��! C ' REGI3TERED Y/ N FEE CURRE� Y/N <br /> Address License# �� �� <br /> � <br /> MECHANICAI. C�MpANY <br /> SIGNATURE REGI3TERED Y/ N FEE CURRE� Y/N <br /> i <br /> ' Address License# r � <br /> � � <br /> t}THER COMPANY <br /> SIGNA7URE REGISTERED Y/ N . FEE CuRREn Y/N <br /> Address � License# � � <br /> ttESIDENTFAi. Attach{2)p!o#Plans;{2}seis of Buiiding'Plans;{1}se ofEnergy Forms;R-O-W Pecmlt for new construction, <br /> Minimum ten(10)working days after submittal date. i�equlreil onsite,ConstrucUan Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliUes&1:dumpster Slte Work•Rermit for subdlvisionsAarge proJects <br /> GOMMERCtAi. Attach{3)complete sets of Buitding P1ans plus a l.lfe Safety Page;{1}set af E�ergy Forms.R O-W Petm�t for new canstruc�on. <br /> Minimum ten(10)working days after submlttal date. equired onsite,Constructian Plans,Stortnwater Plans w/Silt Fence installed, <br /> SaNtary FaciliUes&1 dumpster.Sita Wot1c Permit for Il new proJects.AU commercial reqWraments mast meet camp!lance <br /> SIGN PERMFT Attach(2)sets of Englneered Plans.,,. <br /> ""PROPERTY SURVEY required for all NEW cansWctlon. <br /> Dlrectlon�: <br /> Fill out applicatlon completely. <br /> , Owner&Cantractor stgn back of appf{catlon,notarized <br /> � If over�2500,a Notice of Cammencemerrt is required. (A/C upg des over ST500) <br /> " Agent(for the cantractor)or Power of Attomey(for the awner)would e someone with notarized letter fram owner authorizing same <br /> OVER THE Ci�UNTER PERliINTTING {Frant af Apptication Only) <br /> ' Reroafs if shingles Sewers Service Upgrades A/C Fenc (PIoUSurvey/Footage) <br /> DNvewaya-Not over Counter if an public roadways..needs ROW <br /> � <br /> �_ __ — <br />