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813-780-002U City of Zephyrhills Permif Applica#ian Fax-8'53-7$0-4021 <br /> Building Department <br /> _� Date F:eceived'� Phone Contact for Permitting <br /> Owner's Name /"1 Le-ir"�r�'"' �G'� d /' I Owner Phone Number c5 � ���� <br /> Owner's Address � ,�, �f C�„ U`e Owner Phone Number �— � <br /> Fee Simple Titleholder Name �� � 4wner Phone Number �— � <br /> Fee Simpie Titleholder Address <br /> JOB ADDRESS ��,� 1� �i Y L 'S LOT# �___r�� <br /> suso�vis�ar� � � PARCEL!D# �.� -.2 ���--r�p3d'�.Jt� °— <br /> (OBTAINED FROM PROPERTY tAX NOTICE) <br /> WC}t2K PFtOPOSED e NEW CONSTR 8 ADpIA�T � 31GN Q Q DEMOLtSH <br /> INSTALL REPAIR <br /> PFtOPOSED USE Q SFR Q COMM � 4THEFt <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME [� STEEL Q <br /> DESCRtPTiON QF WORK 'r� u2 {r/1�1�� � � <br /> BUtLDING SlZE SQ FOdTAGE�___� HEIGHT C—_� <br /> �gU��DING �s � VALUATIt7N QF TOTAi.CONSTRUGTION <br /> � - � <br /> ELECTRICA� $ � �Jr � AMP SE VICE C� PROGFtESS ENEE2GY .,., W.R.E.C. <br /> � � ��� <br /> QPIUMBtNG �s_� <br /> { �3� <br /> QNIEGNANlCA� $ VA�UATtfJN OF MECHANiCRL INSTA�LATI4N 1Q <br /> � � <br /> OGAS Q ROOFING Q 3PECIALTY � OTHER � <br /> FINISHEd FLOQR ELEVATIONS ��� FLOOD ZQNE AREA �]YES NO <br /> BUI�QER COMPAM' <br /> SIGNATURE REGISTEREO Y/ N FE�CURRE� Y/N <br /> Address License# �— `� <br /> EI�ECTRICIAI�i ��� � COMPANY � � "� � '� <br /> SIGNATUtltE �'�/'�1..- G�.+'��� REGIS7ERED Y/ FEE CURRE� Y/N <br /> Address License# �� �'� ���� � <br /> PLUMBER CQMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# �� � <br /> MECHANICAC COMPANY <br /> SIGNATURE REGISTHRED Y! N �'EE CuRRE� Y,/N <br /> Address License# �� � <br /> C?THER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y!N <br /> Address ticense# �� � <br /> RE3iDENTiA� Attach{2}Piot Ptans•,(2}sets of Buiiding PEans;{1)set of Energy Forrsis;R-t}-W Permit for new conshvc�on, <br /> Minimum ten(10)working days after submittat date. Required onsi#e,Construc6on Pfans,Stormwater Plans w/Siit Fence installed, <br /> Sanfkary Facilities&1 dumpster;Slte Wark Permit for-subdivisEons!lsr�e praJects----=�--=�- " � " - -- - <br /> COMMERGiAL Atiach{3}complete sets of Bu3lding Plans plus a L�fe Safety Page;{1 j set af Energy Fotms.R-O W Permtt for new construotion. • <br /> Minimum ten(10)warking days after submiktai date. Required onsite,Construction Pfans,Stormwater Plans wl Sitt Fence installed, <br /> Sanftary Facilities&1 dumpster.Site Work Pertnit for all new projects.All cammercial requirements must meet compliance <br /> StGN PERMIT Attach{2}sefs af Engineered Plans. <br /> '"'*PROPERTY SURVEY required for all NEW construction. <br /> t?Irections: <br /> Fill aut application completely. <br /> Owner&Cuntractor slgn back of application,notarized <br /> If over�250d.e Notice of Commencement is requ9red. (AlC upgrades cver$T500) <br /> `" Agent(for the contractor)or Power of Attomey(for tfie owner)would be sameone with notarized letter from owner authorizing same <br /> C}VER THE COUNT6R PERM11TfNG ' " ` (Fron#�of Application Only).�:;�='°�„.�,: <br /> Reroofs if shingles Sewers �• Service Upgrades..A/C,; ; Fences(Plot/Survey/Footage) <br /> 'a � -j�; �,� . . . '• --. __ ��' <br /> Driveways-Not over Gounter if on.pubtic rcsadways..needs RQW'...,,-: <br /> :�F., r.� , .�w. .,�..� ...-. .�.., ..._-� v.. .. ., <br />