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�' 813-780-0020 Fax-$13-780-OU21 <br />� City of Zephyrhills Permit Application <br />' Buliding Department <br /> Date Recelved � . Rhone Gotitast=for'Permittin <br />� � Owner's Narne � 1.�� Owner Phone Num �4 cJ 'oc"'i "' ��7 `t � <br /> � i J�A <br /> �,,�( Owner's Address S"t � �p '� � ' dwqer•Phane Numb r = <br /> Fee Slmple Titleholder Name � � Owner Phone Num6er � , <br /> �,�x <br /> Fee Simple Tltleholder Address °" <br /> ✓JOB ADDRESS `�-"i l.P I�G GCJ'r LOT# C�� <br /> SUBDIVISION � � PARCEL.iD# � <br /> (OBTAINED FR4M PROPERTY TAX NOTICE) <br />, WORK PROPOSED `• NEw CONSTR ADDtACT C� SIGN [� � [� DEMOLiSH • <br /> INSTAI:,L 8' REPAIR <br /> PROFOSED�USE � SFR � CflM{Ul �� OTHER" <br />� TYPE OF CQN3TRUCTION Q BLOCK " [� FRAME � STEEI. Q ' <br /> �y S { <br /> DESCRiPTION OF WOR�._ � � �7�('C r p"l�{j <br /> . <br /> BU!!.Dlt�G SiZE t d�t '`j� �,{�ts�� �Q FpOTAGE � � 2 HEIGHT �� � <br /> ; , <br /> QBIIl�.D1NG ---:t�.�.� . -.,�,.�._. - <br /> � ` � 2���V ,VALUATION pF T07AL CONS`i`RUCT(ON <br /> Q �1 � AMP SERVICE � Q PRQ�RESS ENERGY Q W.R.E.C. <br /> E_ LEC3RICA� $ <br /> „ / <br /> OPLUMBtNG �g� � r/ t nn „j,tl� /,+� <br /> r � <br /> � 7 �� ���'�` ��`� <br /> MECHANICAL $ VA�UAT[4N OF MECNANtCAL INS7ALIATIO�! �� (}P�� „¢ <br /> = r �nr <br /> QGAS Q ROQFiNG Q SPEClALTY-C� {}'FHER � �,�tt�,�?/ <br /> [J <br /> II FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES; IUO � <br /> i <br /> � `� r� <br /> BUtGDER r��MPANX � �,1� <br /> SIGNATURE� .G-e/�—C.�- �� � REGISTERED Y/ N FEE CURRE� Y./N <br /> �d�� Llaense# � �� <br /> EE.ECTRICIAN CBMPANY <br /> SIGNATURE '� REGISTERED Y/ N FEE CURREP Y/N <br /> Address License�#, �� � <br /> PLUMBER COMP,ANY - , <br /> SIGNATURE REGISTERED Y/�.N � FEE CURRE� Y/N. <br /> Address License# �� � <br /> MEGNAt+iiGAL . , GCINIPAAt�!!Y <br /> SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y%N <br /> Address . � . License# �� � <br /> O'FHER - � COMPANY � . <br /> SiGN�►TURE � - � • REG�sTE�p '�Y/ N... ; �cU��n .. ,e Y%N- . <br /> Addreas -.-y.t;> - . . ticanse#`� � <br /> RESIDEN'FIA�a =Aitach{2)..Plo#t Plaits,��2)sets=af'Sult�ing�!?lans;'(1 j set of Energy`Forriis;R-0=W;Pem�i1#:for new.c�nstruc�ion,.,, <br /> , Minimum,ten,(1A)kworicing;day,ssaftec,sutirriltfal date:A Requlred an"s14e;��Constiuction�Plans;�Storinwafer'Plans w/Silt Fence installed, <br /> � �Sanitery�Facilides;&n7t;dumpster;SiterWor,k;Rermitfor,sutidivislonsAarge:prqjects; � '::;^=;'.; '�'� " � - � � <br /> COMMERCIAt. Aitacty.{3)}compiefa'setis'6f`8ii�1[tling P1ai�s ptus a Ltfe Safeiy Page;(1)set of Energy FoTcns.R-O W Permit far naw constructlon. <br /> Minimum ten(10)working days after submlttal date. Requlred onsite,Construcdon Plans,Stormwater Plans w/Silt Fence installed, <br /> SaNtary Facil[Uas 8�1 dumpster.Site_Work Perrrrit for all°new'proJects.All commercial.requlrements must meet comp!lance <br /> StGN PERM17 Attacti{2}"sets of'�nglrseeced.Plans:g;��hr.:..0 • _ .., _s . <br /> •'"""PROPERTY SURVEY reguired for;all,�VEW canshuctlon.;. <br /> Dliectlons: _ .. �. � � � <br /> FIII out appUcatlon compl�tely. <br /> Owner 8�Contrackor sign back.of applicatfen,nofarized <br /> If over 52500,a Natics af 6amrra�ncement i�required. (r4/C upgradss over S75o0) <br /> ,. - �s;�K,r<;;- <br /> Agent(for the conVactor)'or:Poiiuer of.Attar'riey'(fo��lFie owner)wauld be�someone with natarized letter from owner authodzing same <br /> �VER THE Ct1UNTER„PERMtTTIPiG. .�.- �Front of Application OnSy}� --': - , _ , . � . <br /> Reroofs If shingles Sewers Service Upgrades /VC Fences(Fiot/Survey/Footage) � ' <br /> Drivewaya-Not over Caunter if on public roadways..needs ROW , - <br /> I — <br />