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s�a-�so-ooao City af Zephyrhills Permit Application Fax-813-780-0021 <br />� . Bu3lding department <br /> Qate Recetved + °' P.hone ContaeYfar Permlttin `7 - �C+ <br /> Qwner"�Name t�.t !� /4 O Owner Phane Num6er <br /> ownar•s Address '�33 �1�� 1L Owner•Phona Number �� � <br /> Fee Simple Titleholder Namo .� � Owner Phane Number �� , <br /> r�� � <br /> Fee Stmple Tltleholder Address " <br /> JOB ApDRESS � LOT# ��� <br /> SUBD1VISiON � � PARCEL ID# 1�'�..�o `�. - 4 O -�O O L1 - o�Q� <br /> (OBTAINED FROM PROPERTY TAX NOTICE), <br /> WORK PROPOSED `• NEW CONSTR ADDlALT � SIGN Q [� DEMOLISH - <br /> � INSTAI:L � 8f REPAIR <br /> PR4PC13ED USE Q SFR � GOMM Q OTHER" <br /> TYPE OF CONSTRUGTION Q BLOCK " Q FRAME � STEEI. Q <br /> 9S ' j <br /> DESCRIP7IQN OF WORK s ►^��w+.e <br /> BUILDING SiZE �—�� SQ FOtSTAGE��� HEIGHT �_� <br /> .. � r.. <br /> ��,,.r-.E..:>-.�. ..� .,. _. <br /> BUI�Dihlt'a $ <br /> �� VALUATION OF T0'i'AL CdNSTRUCTION <br /> QELECTR{CAl. �S � AMP SERVICE � Q PROGRESS ENEFtGY [� W.R.E.C. <br /> QPl.UMB�NG � -� � � f� <br /> L._� —i � Z �, <br /> QMECHANiCAL $ VAl.UATtOiV OF MECHANtCAL Ii�IS7AltATtON I � 1 <br /> QGAS , [�! ROOFf{VG Q SPECIAt.'FY [� OTHER <br /> FINISHED FLQOR ELEVATIQNS (��� FLOOD ZONE AREA �YES. IVO <br /> L <br /> BUiCDER COMPAt+tY <br /> SIGNATURE REGISTEREp Y/ N Fee CURRen Y./N <br /> Add�es� Liaense# � � <br /> E�ECTRICIAN COMPANY <br /> SIGNATURE �' REC3ISTERED Y/ N FEE CUI2REA Y/N <br /> Address � , . , �License# � � <br /> ALUMBER COMBANY <br /> SIGNATURE REGISTEREp .Y/-N FEE CURRE� Y/N. <br /> Addreas " License# � � <br /> NIECHAi+1[Cl�t: " . .:COMPANY • <br /> SIGN14TURE � RE�ISTERED Y:/ N FEECURREP Y%N <br /> Addrsss�` ' ; _ , License# � � <br /> OTHER � ' CQMPi4PtY - {• 1J��- , , ' <br /> SIGN�TURE REGISTERED �Y/ N.. � •'FEE CURRE� ; Y�%,. <br /> Addre$a � �! ''M:� . L'tcense#• `CC C-d`,a'�'7��Z..-�-� <br /> ;... .,.,....-.• - s- . _'. .. .�,. ,. .�..: �--s.. 3'�.c� >;•r.r.•, � <br /> RESIDENTIAt... :� Attach{2);P-,Ict.Ptans;.{2}sets:of`Butlding Ptans;-{1}set of.Energy`Fomis;rvR�Vtt+Pennit:for;riew;,cor�s#ructian, � <br /> Minimum}:ten;,(10);.woriting;days°after„subr►ilttal.date:�:Requlred onsite;=Constr�cBon�PlBns;�StormwaterPlans w/Silt Fenc,e installed, <br /> "Sanftary Facilides�:8��1;dumpstert8lte�,Work:Permit for,sutidivislonsllarge proJects�:..� •:"`;'. '. " � � <br /> CQMNIERCIRL A#fach{3}��mplete sefs'of 6u1td1`ng P1ans plus a Ltfe Safety�Page;{1}set o�Energy Fqrms.R-O-W Pertnit for new canstnsc�lon. <br /> Minimum ten(10)workfng days�after submittal date. Required onsite,Construc#1on Plans,Stormwater Plans w/Sflt Fence Installed, <br /> Sanitary FaciltUes li 1 dumpster.Site Work Penntt for all neuv`proJebts,AI!commercial requlrements m�st meet compllance <br /> SlGN PERMlT Attacti{2}"sets of'Eng,i`nee�:Plans:;;.,r��;N;� � . - ,- ' <br /> '""'PROPERTY SURVEY reguired for;all NEW constr,uctton: <br /> Dlreatlons: - , , - . <br /> Ffll out appUcatlon completely. <br /> Owner&Cantractor stgn back-of appitcaflon,notadzed <br /> If over$2500,a Notice af Gommencement is required: (A/C upgrades over 5T500) <br /> .. ''.�i cr�,;.;,; <br /> Agent(for ttie�conVactor)`or'Power�of Attortiey(for the owner)wuuld be someone with notarized letter from owner authorizfng same <br /> 'OVER'TH£CC3UNTER:P.ERM1TCENG.-.- - (Front-of<APplicat�on Oniy) � � " <br /> Reroofs if shingles Sewers Service Upgrades A/G Fences(PIoUSurvey/Footage) <br /> Driveways-Rtot aver Counter if an publlc rosdways.:"neeiis RC1W <br />