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_ <br /> ���-,8�-�,�`U Gity af Zephyrhills Permit Application Fax-813-780-0021 <br /> � Building Department <br /> Date Receiv�t! "` �� Phone Contact for Permiktin ��� � t� - ���� <br /> � <br /> Owner's Name ��l�'1-`�'� �1'`� � � Owner Phone Number ��3- '�CS��- ��� <br /> Owner's Address Owner Phone Number � � <br /> Fae Simpie Titleholder Name �- �� Owner Phone Number �` � <br /> Fee Simple Titleholder Address <br />� JOS AdDRESS �BJ.j C� �v+� �I aa�' LOT# C_�_� <br /> I <br /> �t_'� �� '� �l�o`' <br />� suBO�v�s�ar� � PARCE�!d# <br /> � (OBTAfNE4 FROM PROPERTY TAX NQTIGE) <br /> WORK PFiOPOSEQ e NEW CONSTR 8 AQD/ALT � SIGN � Q QEMOI.lSH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM C� 01"HER <br /> II NPE OF CONSTRUCTIQN Q BLOCK Q FRAME [�� STEEL Q <br /> DESGRIPTiflN OF WdRK �''Q Q 1�C� M��e,-� c��-�. �q�y,,� � j �ex�6-Zn �7vt� t �?S cD� �►�..-rz� <br /> SUltDING SlZE � � SQ FOQTAGE�� HEIGHT ��� , <br /> Q BUILDING ��� 1/ALUATION OF TOTA�CONSTt2UCT10N <br /> LEC7RICAL $ �h/� � � AMP SEF2VICE �z'� Q PR@PI�E��EN�F2GY Q W.R.E.C. <br /> QPLUMBINC3 $ � ��� I <br /> ��� �� <br /> QMECHANICAL ($ ^ � VALUATION OF MECHANICAL INSTALLATION <br /> � <br /> QGAS Q ROQFING Q SPECIALTY 0 OTHEF2 <br /> =1NISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA [�]YES NO <br /> 3UILDER -_i� COMPANY <br /> >IGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � ^ � <br /> eLECTRICIAN �v^y,t,� �{o��`s'ic� CQMPANY -'�l ��` �� �/�c�`"`�� s�-'�+�� <br /> i1GNATURE REGISTERED Y/ N FEE CURR6� Y/N <br /> 3e.._..,_,.. t n�- t <br /> Address 1 F'6 ,� �c'�L c.��c.�' �.� ,�L.33d Y� t�cense# �C 13� a�'Y�16 � <br /> �LUMBER � � COMPANY <br /> iIGNATURE REGISTERED Y/ N FE@ CURRE� Y/N I <br /> Address tacense# �^ � <br /> �ECHANICAL �- COMPANY <br /> �t�NATURE � � REGISTERED Y J N FEE CURRE� Y/N <br /> Address License# � � <br /> ►THER COMPANY <br /> �IGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# �' `� <br /> ;ESIDENTIAi. Aktach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new constructian, <br /> MinEmum ten('SO}worktng days after submittal date. Required onsite,Construction Pians,Stormwater Plans w/Sitt Fence instailed, <br /> Sanikary Facillties&1 dumpster,Site Work Permit for subdivisions/large praJects <br /> OMMEFtCIAL Attach(3)complete sets af Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new conslrucUon. <br /> Minimum ten(10}working day�after submittai date. Required onstte,Construct?on Pians,Stormwater Ptans w/Silt Fenc�Installed, -�-- <br /> Sar�itary Facilities&1 dumpster.Site Woek Pemtit for aii new proJects.RtI commerciai requireme�ts must meet comptiance <br /> IGN PERMIT Attach(2)sets of Engineered Plans. <br /> "'*'PROPERTY SURt/EY required for all NEW cons#ruction. <br /> Irectlons: <br /> Filt out appiicatian completety. <br /> Owner&Contractor sign back of apptica�on,natarized <br /> If over�2500,a Notice of Gommencement Is required. {AIC upgrades aver�75Q0) <br /> Agent(for the cantractor)or Power of Attomey(for the owner)woufd be someone with notarized letter from owner authorizing same <br /> VER THE GOUNTER PERMITI'ING _,(Front of Applira6on Only) _K. - <br /> eroafs if shing�es Sewers Service Upgrades A/C•;�,�;,Fences,(PIoUSurveylFootage) <br /> . � , - � ,� , - , <br /> Driveways-Not over Counter tf on pubUc.roadways::needs ROW � � <br /> .t , ,' <br />