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S ; <br /> 813-780-0020 City of Zephyrhills PermitApplication Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contactfor Permitting ( } � �� -�Q <br /> _�_� � ���_�-� �- - - - - - -�-�-�-�--� - <br /> Owner's Name pwner Phane Humber <br /> Owner's Address 4 Owmer Phone Number �— �� <br /> Fee 5imple Titleholder Name Owner Phone Number �— �1 <br /> Fee Simple YtleholderAddress <br /> JOB ADDRESS � � � LOT# (,� <br /> SUBDIVISION ��j ta� !� PARCEL ID# ,�- ' ( - (� <br /> {OBTAINEU FROP.7 PROPERTY TAX NOTICE) <br /> WORK PRdPOSED e NEW CONSFR 8 ADdIALT � SIGN Q � DEMOIiSH <br /> INSTALL REPAIR <br /> PROPdSED USE � SFR 0 COMM � OTHER <br /> TYPE OF CONSIRUC�ION � BLOCK Q FRAME C] STEEL Q <br /> DESCRIPTION OF WORK �i :l� Sf <br /> BUILDING SIZE � � SQ FOOTAGE� IiE(GHT C�� <br /> BUILDIhlG �� •-. �,ry� VALUATION OFTOTAL CONSTRUCTION <br /> � <br /> �EiECTR3CAL � � AMP SERVICE 0 PRQGF2ESS ENERGY Q W.R_E.G. <br /> �P�UMBING � ��`Q�(}�� �..�-�, <br /> MECHANICAL VALUATION OF MECHAAlICAL INSTALlATiON � ��j'�4�� ,��� <br /> � � • �� ���1�� <br /> 0 GAS [� RQ�FI NG Q SPEClRI.TY [� QTHER �� C�� � `' �� <br /> FINISHEDFLOORELEVATIONS FLOODZONEAREA QYES NO ��_ `�,}" - ��� <br /> °�°�} , � <br /> v <br /> � <br /> aus�o�� �.. _ `�4NIPANY ���-=.�,� ��3����:.2� <br /> SIGNATURE REGI9TERED Y/ N FEE CURRE� Y/N <br /> Address 2�. License# � �1 <br /> EI.EClRIG1AN � � COMPANY <br /> S�GNATURE REGISTERED Y I M1I FEE CURf2E� Y I hJ <br /> Address License# �� �� <br /> PLtlMBER �� � COMPANY <br /> SIGNATURE REGlSTERED Y J N FEE CURRER Y J N <br /> Address License# �� � <br /> MEGHANlCAL COMPANY <br /> SICaNATURE REGISTERED Y I N FEE GURRER Y I N <br /> Address License# �� _ <br /> OTHER � COMPANY � <br /> SIGEIATURE REGISTERED Y I N FEE CURRER Y I N <br /> Address License# � -�1 <br /> tltlt ! / It ( il / ttIIIlIEIIIltIlII1IIItIII / lIItIIItIlIIIliIIl111 � lIII { 1 <br /> RESIDEN7IAL Attach (2)Plot Plans; (2)sets of Buiidng Pians;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> ---_ ___ _--_- ----;,��n��num fer{iCj wcrhinc�-da;�s after suu��nitiai-dete_ Requi�eti Unsite,L�nstruZtE�,n P�ans,StormGVater Plans wI"Siit Fenceins�allea, - �� --�' <br /> Sanitary Facilities 8 1 dumpster,Site Work Permit for subdvisionsllarge projecis <br /> COMMERCIAL Attach (3}complete sets of Building Pians plus a Life Safery Page;(1)set of Energy Forms.R-O-W Permit for new construction. ; <br /> Minimum ten(10}tivorking days after submittai date. Required onsite,Canstruciion Plans,Starmwater Plans w!Silt Fence instafled, <br /> Sanitary Faci(ities&1 dumpster Site Work Permit for ail ne�v projects.All commercial requirements must meet compiiance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""`PROPERTY SURVEY required for aii NEW canstruction. <br /> � ■ • • � • e � / � e • • � • � ■ • � ■ r � � • • ■ • • � • ! e � • • e • ■ • � � • � f ■ • e • • • � f e e ■ ■ ■ ■ ■...! ■ ■_.f...■ LI....l _ <br /> Directions: <br /> F7!out application compieTely <br /> Owner&Contractor sign baek of appfication,notarized <br /> If over$2500,a Notice of Commencement is required. (A!C upgrades over$7500) <br /> "' Agent(for the contractat}or Potver af Attorney{for the owner}would be samaone with notasized lefter fram olvner authorizing same <br /> Ol/ER THE COUN'IER PERMITTING (Front of Application Only) <br /> Reroofs if shing(es• Sewers Service Upgrades A�C Fences(PIoUSurveylFootage) <br /> Driveways-Not over Counter if on public roadtivays..needs ROW <br />