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I��1 <br /> �,s-,�u-���� City of Zephyrhills Permit Application Fax-813-780-0021 <br /> f , <br /> �;, Buitding Department <br /> date Recefved Phona Contaat for Permitting ��✓ �d o� – 'dJ Q L� <br /> Owner's Nama L"'l�1F►'1J? ���J�G3N 8wner Phone Number p��°" 3��"' �Cl� �� <br /> Owner's Address ll��P �25 1 � e•@� Owner Phone Nember �� � <br /> Fe�Simple Titteholder Name � � Owner Phane Number �� � <br /> Fee Simple Tltleholder Address <br /> JOB ADdRESS � /.!��� lX�v�� �, �� �e �i j21�!L�S �`�, ��O�# [� <br /> suso�vis�or� ��i~L• ��t.t�r�� Q,���L�� �a' �� �l Q�/!.� ���D /1`�� <br /> (OB7AINED FROM PROPERTY TAX NOTtGE) <br /> WORK PROPOSED e NEW CONSTR�AQDlALT �� SIGN' Q Q DEMOl.ISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTIQN Q BLOCK [� FRAME [� STEEL Q <br /> DESGRIPTiON OF WORK JT��11� ° � �/LI �' ��� 7��-'� Lt-1J� "" r� d/►��l1�� <br /> BUILDlNG SIZE � � SQ FOQTAGE['� tiE1GHT �__� <br /> QBUILDING $ � VAItlATION OF TOTAL CONSfiRUCTIQN <br /> [�ELECTRICAL ($ � AMP SERVICE Q PROGRES3 ENERGY Q W.R.E.C. <br /> � _ <br /> QPLUMBING �>� � � f�O r <br /> ti f <br /> OMECHANICAL $ �� �7�0 �� VALUATIQN QF MECHANICAL WSTALLATION <br /> / <br /> QGAS Q ROQFING Q SPECIALTY Q O?'HER <br /> =1NISHED FLOOR ELEVATIONS �—� FLOOD ZONE AREA QYES NO <br /> �UILDER GOMPANY <br /> 31GNATURE REGISTERED Y 1 N FEE CURRE� Y/N <br /> Address License# � �� <br /> 3LECTRICIAN C011lflpAJ+11( <br /> fIGNATURE ,_ REGI&TERED Y/ N FEE CURREh Y!N <br /> Address License# �— � <br /> �I.UMBER � COMPAIdY <br /> ►1GNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Add�^ess License# � �� <br /> ` ,1�:7 A'/-�/�'S !'�•9-11P�C� "y" i' <br /> IIECHANICAL ,'l�d'Y��Q �%�y�L(�i'X-P-2.. COMPANY � 'y � � <br /> �I�NATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> AddCASS 7�7l �`!P� �r ,G.'" J� VJ �� License# ��.p 1j+�'�° �'�� <br /> 1THER COMPANY <br /> �1GNAfit3RE aE��sreaeo Y/ N FEE CURRE� Y/N <br /> Address - �lcense# �� �� - - <br /> ;ESiDENTtAL At#ach(2}Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Perrnit for new construction. <br /> Minimum ten(10j wotking days atter su6mtttal date. Required onsite,Construction Pians,8tortnwater P�ans w/Silk Fence installed, <br /> Sanitary FaciAties&1 dumpster,Site Work Permit for subdivisions!large pro�ects <br /> OMMERCIAL Attach(3)complete sets af Building Plans plus a Life Safety Page;(1�set of Energy Forms.R-Q-W Permit for new constructian. <br /> Minimum ten(10}working days after submittal date. Required onstte,Canstruction Plans,Stormwater Plans w/Silt Fence installed, ' <br /> San(tery Facilities&1 dumpster,Slte Watk Permlt for ati new pro]ects.A!f commerciai requ(rements must meet compliance <br /> 1GN PERMIT AHach(2)sets of Engi�eered Plans. . <br /> "*'PROPEF2'CY SURVEY required for alt NEW aanstruction. <br /> Irections: <br /> Fii!out appticatian compfetety. <br /> Owner&Gontractor sfgn back of applicat�on,rtatarized , <br /> If over S250q,a Notice of Commencement Is�equired. (AfG upgradss over$7500) <br /> Agent(for the cantractor)or Power of Attomey(for the owner)would be someone with notarized let#er from owner authorizissg same <br /> VER THE COUNTER PERMITTING (Front of Application Qnly? <br /> eroofs if shingles Sewers Servlce Upgrades A/C Fences(PIoUSuroey/Footage) <br /> DNveways-Not over Counter tf on publlc roadways..�eeds ROW . <br /> ii <br /> i <br /> , I <br />