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\ <br /> is�saso-oo�o City of Zephyrhills Permit Application FaX a�sasaoo2� <br /> Butlding Department <br /> � _ �,r .. , � . I *,.+`t n`` .. " . ° <br /> Date Receiv��i " � Phone CoetactEar P�rmittln . ( � . � . � . . <br /> ;_. , <br /> , . �� .;, -,,t;s�, . ' ;= .; ' �. �._�.. ..,. - _ . <br /> Owner's Name t'1. ��?"G�Vti. "+ .' �- ` Owner Phane Neisn6ar':t . .�� ; , . � <br /> Owner's Address ��Q� �I�DI'� f�Q �Y� 7��`', rl /'�I1��� ��pwner Phone Number r p�� � � � <br /> ���. � <br /> Fee Simple Tltleholder Name � � � Owner Rhone Number � <br /> i <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS lQ � IL-�bV`VY1 � t�'1• � , LS l� 3 3J�-Io� LOT# ,�� <br /> SUBDIViSIQN �-�.2: h2 'n S �1�n�.�'J��' PaRC��.ia� a 3-�tn a - a 7�—�d DOD D j�'b <br /> �—�C.�Iejn (OBTAINED FRpM PROPERTYTAX NOTICE) ' <br /> WORK PROPOSED NEw CONSTR ADDlAL,T [� 81GN Q Q DEMQLISH <br /> e INSTALI. 8 REPAIR <br /> P32UPOSED USE Q SFR Q CON1M C� OTHER <br /> TYPE OF CQNSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTIQN OF WORK Iu �6� <br /> � <br /> BUILDING SI2E � � SC FOOTAGE 2�� �P� HEIGHT C�„ � <br /> ,__ ,,,._,,,, <br /> ���������`' � VALUATION OF OTAL CQNSTRUCTION <br /> QEl.ECTRICAt. � � AMP SERVECE Q PFiOGF2ESS ENERGY Q W.t2.E.C. <br /> , <br /> �PLUNt81NG (�>� <br /> � ��� � <br /> I QMEGHANICAL $ VAI.UATION OF MECHAN1CAl Ih1STA�LATlON � <br /> 1'�,�,1 a�" <br /> 'I - _. QGAS [,� OOFlNf� Q SPECIA�TY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD xONE AREA QYES NO <br /> 'li <br /> BUl�DEi2 COMP� YYJQ� �L�()�J1'I <br /> SIGNATURE R IST R FEE REI. <br /> EG E ED / N CUR Y/N <br /> i Address {L � ( L(cense# � � <br /> ELECTRiC1At�t COMPANY <br /> SIGNATURE REGISTEI,RED Y/ N FEE CURRE� Y/N <br /> � <br /> Address � Ucense# � � <br /> � PLllMBER COMP� <br /> SIGNATURE REGISTF�RED Y/ N FEE CURRE� Y/N <br /> Address I License# ��i � <br /> MECMAt`F}CAL C{�MPAI NY <br /> SIGNATURE REGIST�REO Y/ N FEE CURRE� Y/N <br /> Address � License# �� �� <br /> OTHER COMPANY YYlQ,Y? K�S�! � <br /> SIGNATURE REGISTER6D / N FEE CURRE� Y/N <br /> i <br /> �►d�ess �tt1��� S��� �,� `� 33S?# Ucense# ��C 13�5�S � - <br /> � <br /> RESlDEN'[IAi: Attaah(2}Plat Plans;.(2}se#s af Bu1lding Plans;{i)set of E�ergy Forms;R-O»W Pennit for new consUvc�an, <br /> Minimumrten;(1,0).working,d'ays after.submittal date. Required onsite,Construcaon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadl(Ues;&1:dumpster Site Worfc Permit for subdiVislonsAarge proJects <br /> COMMERCIAL Rttach{3)complete sets af Buitilirig Pians ptus a C[fe Safeiy Page;{1}set of Energ}r Forms.R-O-W Permit far new construction. <br /> Minimum ten(10)working days after submittal date. Requi�ed ansite,ConsUuction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles&1 dumpster.Stte Work Permit for all new proJects:A!I commercial.requlrements must meet compliance <br /> StGN PERMIT Attac#i{2)sets of Engineered Plans.. . � <br /> """'PROPERTY SURVEY requlred for all NEW constn�ctlo . <br /> DlreCtions: <br /> Fi�l out applicaUon completely. <br /> Owner 8 Contractor sign back ot appiication,notarized <br /> tf aver a2504,a Notiae af Commenceme�rt ts reguired. (AtC vpgrades over�T500j <br /> " Agent(far the contractora or Pawer of Attomey(for the owner)would be someone with.notarized letter from owner authorizfng same <br /> OVER THE COUNfiER PERMITTING (Front of Applicatian Only} <br /> Reroafs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Foatage) <br /> Driveways-IVot over Counter if on pu6lic roadways..�eeds ROW <br /> . � <br />