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� _ <br /> 813-780-0020 ` s City af Zephyrhills�Permit Application Fax-813-780-p021 <br />( Bufiding Department <br /> � � � �7p C <br /> Qate Received Phone:Contact�for P�rmitfln �t� !tt�- — J �l <br /> Owner's Name • � Owner Phone Humber ���— ,� �J <br /> Owner's Address �/ '��3 C��� �l�� ��ST/ Owner Phone Number �- � <br /> Fee Slmple Tltleholder Name � � Owner Phone Number' � � <br /> ! <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ���! C.,�G d/ �✓�. C�H'/�b /ZO LOT# �� <br /> SUBDtY1SiON �Q��' t`�`OIl.�1�r^v+' PARCELID � �� �1 I�1�� �l���l� /��� <br /> l,� <br /> ' (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WBRK PROF{}SED , e NEW CQNSTR ADDIALT C� SIGN Q Q DEMOI.ISH <br /> INSTALI.. FtEPAIR <br /> PROPOSED:USf Q SFR [� 'GtaMM � OTHE12 <br /> TYPE OF CONSTRUCTION � [�` BLOCK "'`[� FRAME C] STEEL [�, <br /> DESGRtPTIONOFWORK + ��� � T / l3j�I �7 � ClJ7"Y)• ON�l4.j� <br /> BUI�DiNG S1ZE �� � 8Q FOOTAGE�� HE{GHT .C�_� <br /> i <br /> �—... ..,,. <br /> �g�«����'" f'" � VALUATION�OF TOTAC CONSTRUGT101V <br /> L_�.— �J <br /> QE�ECTRICAI $ AMP SERVIC� [� PRQGRESS E1dERGY Q W.R.E.C. <br /> � � . <br /> QPl.UMBING �$ � ` <br /> �. <br /> QMECHANlGAt: $ VALUATION qF ECHANICAI tNSTA�LATIQN <br /> �°/��;v�. <br /> QGRS Q RQOFING..;Q SPECIAk.TY � OTHER <br /> FINISHED FLQOR ELEVATIQNS �� FLOOD 20NE AREA QYES NO <br /> i , <br /> BUIL�ER COMP ' <br /> SIGNATURE REGISTE�ED Y/ N FEE CURRE� Y/N <br /> Address �ticanse# � � <br /> E�EC7RICIAN COMPAt�tY <br /> SIGNATURE ��� REGISTE�ED Y/ N FEE CURRE� °Y/N <br /> Addresa � -Ucense#. " <br /> F�UMBER _ COMPAIiIY <br /> SIGNA7URE k.REQISTERED Y/ N. FEE CURREA Y/N <br /> r <br /> , Adclress ( License# � � <br /> �ECt��v�ca� -_:y�� Y , � coMa� �i�tt�2 5 �,g �f--`/�'-�" <br /> /�GQ�.�['J�.` .EE En Y ;N <br /> SIGNATURE / REGISTER�o Y/ N F CURR / <br /> Address ' � `T�/ lIE'N G"�Q ,�`l7jlLGS '� 1 License# +L��l�U�''T� <br /> OTHER COMP� <br /> '� SIGNATURE ' * REGISTER�D Y/ N� FEE CURRE� Y/N. <br /> Address ' - �icense# � � <br /> � <br /> i2ESIDENTIAL Attadi(2}'.Pla#.Plans;:{2}'sets:of='Bulldln�';Plans;,{1}'set af�Ener�y�Fonns;R=0-W Permit for new canstruction, <br /> �Minimum:ten_(:1,0)�working,�days;after�sutirrilttal date:::Requlred.ons(te,Gonstniction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary�Facilitles,�&,1:,dumpster°SIte:Worlc;Perm(t.for subdfyislons/large proJects;;`, ` <br /> COMMERClAi. Attach{3)coinpiete seis of 8u11ding Pians plus al.[fe Safetyr i?age;(1}set of Energy Forms.R-0 W Petmlt far new constniction. <br /> Mlnimum ten(10)working days after submittal date. Required onsite,ConsUuction Pians,Stormwater Plans w!Silt Fence installed, <br /> Sanitary FaGtitles 81 dumpster.Site Work Permit forall new proJeot's.All commercial requlrements must meet compllance <br /> ' SIGN PERMIT Attacfi{2)sefs of Engtneered:Plans.,.. -�Y , � �. . _ - _ . <br /> •'"'PROPERTY SURVEY required for all NEW canstructian. " <br /> � Dlrection�: , - <br /> ', Ffli out app8catlon completely. <br /> � Uwner&Gontra�tor slgn back of applicattan,notar�zed ' <br /> ' if avsr�2500,a Notice of Commencement is rsquired. (AlC upgrades�ver;7500) . <br /> �� I <br /> Agent(for the contractor)`or°Povuer of Attamey(f6�the owner)would be someane with nofarized letter from owner authorizing same I <br /> DVER THE COUNTER PERMITI'FNG;;, � (F�iit=i►f'Ajipfiir:�tion;OntY)y°;'r�_;.,:--...y,.;, �-_ � <br /> Reroofs If shingles Sewers `�Service`.Upgrades:ALC;;�,;�.F.erices(PIoUSurvey/Footage) • <br /> � ���i!�' i '.', }3i .;�.. '. •� ' ' <br /> �f <br /> Drivewaya-i+tot over Counter tf an,pubtic�roadwaiys`.:needs iROW p <br />