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a�s-7aa-oazo City af Zephyrhills Permit Appi�catian Fax-813-784-0021 <br /> Building D,epartment <br /> Data Received �,'' • ��� �� � � � <br /> Phone Contact for Permftting <br /> 1 1 1 1 1 1 1 1 1 1 1 i 1 <br /> Owner's Name �...� Owner Phone Number '� � — pZ <br /> Owaer's Address � t7�t?t}L�' 4wner PE�one Number �� � <br /> Fee Slmpie S3tteholder Name � �_ � Owner Phone Number � <br /> Pee Slmple Tltleholder Address <br /> JQB ADDRESS � S (,J�f�1 . � � � ��/ � LOT# ���'�f�� <br /> SUBDIVISION ►� ,�O`�,liJ�� ��1'�� PARCEL ID# 'o2�P�I ' GI O` O�OO(f- /09b <br /> {t}BTASNEp FR4M F'i20PERTY TAX NOTtCE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � 51GN Q O DEMOLISH <br /> INSTAL� REPAlR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE QF CONSTRUGTION Q B�OCK Q FRRME � S7EEL Q <br /> DESCRIPTION OF WORK �r�' � ��U(` �� I�tce�y�-�- .�j.�y��r��Z �', �4� X � <br /> BUILDING SIZE � � SQ F007AGE CT� HEIGHT �� <br /> �BUILDING $ �� O�� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL � � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBtNG � � �` ",-�- � <br /> „ _ A �tY��� 4`1 <br /> � �! �`4, � <br /> MECHANICAL $ VALUATION C7F MECHANiCA�INSTA�IATIOR! t^ <br /> ���,, <br /> QGAS Q ROOFING Q SPEGIAITY 0 OTHER ' <br /> FINISHED FI.00R EI.EVATIONS ��� F�OOD ZpNE AREA QYES NO <br /> r'- <br /> BUILDER r /, ry t�COMPANY JJ($Ctt t��'� �--�C90 � �. � <br /> SIGNATURE G��-K!��:�'C� REGIS7ERED N FEE C RREN Y N <br /> Address .$ ,�j� // P: License# �S�-Iasy79l I <br /> ELECTRtC1AN � COMPANY <br /> SIGNATURE REGIS7ERED Y/ N FEE CURREN Y/N <br /> Address License# C � <br /> PCUMBER CQMPANY <br /> SIGNATURB REGIS7ERED Y/ N FEE CURREN Y/N <br /> Address License# �� � <br /> MEGHANICAI. � G4MAANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address license# �— � <br /> 4THER � CQMPANY <br /> SIGNATURE � REGISTERED Y I IV FEE CURREN Y/N <br /> Address License# � � <br /> Illllllllllllllllllllllllllllllllllllllllllllllllltlllllllltlllllll <br /> RESIDEHTIAL Attach{2}Plot Plans;{2)sets of Building Pfans;{1}set af Energy Forms;R-O-W Permit for new canstruction, <br /> Minimum ten(10}warking days after submittaf date. Required onsite,Gonstruction Plans,Stormwater Plans w!Silt Fence'snstalled, <br /> Sanitary Facilities&1 dumpster;Site Wark Permit for subdivisions/large projects� __ �_- � <br /> -- C�YiNiERCiAt—�Aftacti{3)"comp�ete sets"of Buiiding�Plan"s ptu�s a Gife Safety Page;{�}set of Energy Forms:R-0-W Permit for new construction. <br /> Minimum ten(10}working days aiter submittai date. Required onsite,Gonstruction Plans,Storrnwater Plans wt Siit Fence insfa(led, <br /> 8anitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> S(GN PERMtT Attach{2)sets of Engineered Plans. <br /> •**`PROPERI'Y SURVEY required for a(i NEW construction. <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ._. <br /> Dlreetfons: <br /> Fiii out appiication compieteiy. i <br /> 4wner&Contractor sign back af application,notarized <br /> if over$250d,a Natice of Commencement(s required. {AfC upgrades avar$7500) � <br /> " Agent(for the oontractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTINC's {Front of Rppiication flnly) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(P1otlSurvey/Footage} , <br /> � <br /> Driveways-1Vot over Gaunter if on public roadways..needs f20W <br />