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��aaao-oazo City of Zephyrhills Permit Applicatian Fax 813-7aaoo2� <br /> Building Department <br /> Date Recelved � .., .._ ._:.i"`�3 '��.� .,.. _.' 9!.'!� f . <br /> Phone Gontact fo�Permi4tin :.' Z� <br /> 5• i. �' <br /> Owner's Name �D�i��U> .SI�i+�t ��L i � D iN S �IrC �Ownec Phone Number� ��3 -;7/S-�y�`�� <br /> Owner's Address �� '� � �0 p� U�`�b J2��i-� `Owner Phone'Number N �! � <br /> Pee Simp�a Titiehotder Name � � Owner Phone Number ,� � <br /> Fee Simple Titleholder Address <br /> JOB ADDP2ESS .�G d�1 L v j��_L l�r3 t� z}�� .. LOT# �___� <br /> Sus�#ViSSO� � � Partc�L ro# �'�'��° ��- o���- a a 1�� - a�`��' <br /> (OBTAINED FROM pROPERTYTAX NOTICE) f <br /> WORK PROPOSED , e NEW t4NSTR 8 ADDJALT � SEGN Q [� DEMflLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFf2 Q CQMM Q OTHER S� 7-� t,�p�� <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DEBCRtP"C10T�OF WORK S)� D rc 7C jso c�ra1K� t,�i�'ia t3�w Lti�F"�G'+t l��z p�*} �„ "'car��r � i l�S� (�o <br /> �iUiLDING SIZE � � SQ FQOTAGE�-1 HEIGHT ��� <br /> �s;�.���Ry�,, � W���Ga� VALUATION OF TOTAL COt�STRUC'TiON <br /> �J <br /> [�ELECTRIGAL �>----^M� AMP SERVICE Q PROGRESS E�lERGY [� W.R.E.C. <br /> QPLUMBING �>-___--� � � /' � ..�y <br /> � �� ,� <br /> QMECHAMCAL $ VALUATIQN OF MECHANIGAL.(NSTALLATlON _ <br /> QGAS [� ROOFING Q SPEClALTf C� OTHER <br /> FtIVtSHED FLOOR ELEVATtONS �_� FLOOD ZONE AREA [�YES NQ <br /> ,,, ^, ,_„_.,,, „_„_., <br /> BWLDEE2 �'. f COMPANY . T!�t� GOY1�" - <br /> StGNATURE � � �" �+ "~ REGISTERED Y/ N FEE CURREI� Y/N � <br /> Addrass I.Icense# ��C' � ��'� 1� -i�� <br /> E��CTRiG1AN" CQMPANY � <br /> S1Gi�ATURE , ,, " RE�is7Etteo Y! N FEE CURRE� Y/N <br /> A�re�s Ucense# � � <br /> P�UMBER � Ct}MPANY <br /> SIGt+tATUR6 REGISTERED Y! N FEE CURRE� Y/N <br /> Address E.icense# �� �� <br /> MECHANICAL COMPANY <br /> SIGNATIIRE REGtSTERED Y J R1 FEE CURRE� Y/N <br /> Address l.lcense# � 1 <br /> OTHER COMPANY <br /> SlGHATURE RE�ISTERED Y J A! , FEE cuR�tEt� Y/N. <br /> ,,,,,,_._., „_—,,,, <br /> Address lEcense# � � � <br /> RESIDENTIAL Atkach(2)Flot Plans;.(2)seks of Building Plans;{1)set of Energy Fotms;R O-W Permik for new consUuation. <br /> Mlnlmum ten(10}working.d�tys after.submlttal date. Requited onsite,Ganstruction Plans,Stonnwater Plans w!Sitt Fence installed, <br /> Sanitary Fac111Ues&1 dumpster,Site Work Permit for subdivislonsAarge proJects <br /> COMMERCIAl. Attach(3)camplete sets of Building Plans plus a Life Safety Page;(7}set of Energy Forms.R-O-W Permit for new constrvction. <br /> IUlinimum ten(10)working days after submlttat date. Required ansi#e,ConstrucNan Plans,StaRnwater Pians w/Sit#Fence Installed, <br /> Sanitary FacilPtles&1 dumpster.Site Work Permit for all new proJects.All commercial requlrements must meet compllance <br /> SIGN PERMIT Attach{2)sets of Engineared Plans.. <br /> ""PROPERI'Y SURVEY required Eor ail NEW construction. <br /> Dlrectlons: <br /> F311 aut applice�on completely. <br /> Owner&Contractor sign back of appl(catlon,notaHzed <br /> 1f aver 52500,a Natice of Commencero�ent i�required. {RtC upgrade$over�75QQ} <br /> `" � Agent(for ihe contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> C7VER THE GOUNTER PERMITTING (Front of AppticaUon Onty) <br /> Reroofs it shingtes Sewers Service Upgrades A/C Pences{PlodSurveyJFootage} <br /> Driveways-No#over Caunter if on pubitc roadways..needs ROW <br />