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1 <br /> t� � � <br /> _ � � <br /> a�aaao-ooza City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Buitding Department <br /> • Dete Recalvcd —� phone Contact for Pertnitti�a 1 - � � <br /> 'C""iTC"ti 1 f t s-r-e--c-rt-r-se--r�x-r'rrr•e-�T-r ��� � ��� .. j-r--e-=-e...:--r�-:� <br /> OwnePs Name � Owner Phone Number <br /> Owner's Address 1��.�¢����1y���� Owner Phone Number � � <br /> Fee Simple Tltleholder Neme �� Owner Phone Number <br /> Fee Simpla Tltleholde►Add 5 I� <br /> JOBADDRESS ( -- lOT�I �� <br /> SUBDMSION �i�� PARCEL ID# - <br /> (09TNNE0 FRbFA PitOPER7Y TAX N6TtCE) <br /> WORK PROPOSED � NEW coNSTR 8 ADD/ALT [_] SIGN � Q DEMOUSH <br /> INSTALI. REPAIR <br /> ARpFO5Eq USE Q SFR � COMM � GtTHER <br /> TYpE OF CONSTRl1CTION � BLOCK Q FR,4ME C,� STEEL O <br /> - - - -_ _ - -DESCRtPT10NOFWORit s��.� �ra�+�e Scrl� �o�tatwf S,�w ar� "z..r'rr, ie hi�tfl�ECw.��-v'� h'� �° F�js <br /> �/"�c�+^�c- <br /> 8UlLQtN6 SIZE � � SQ FQQ7ALRH 3�a��t � tlEt6FtT �r� <br /> �BUILDING � QQ d_Q a VALURTIOFI OF TOTAL CONS7RUCTION <br /> �]ELECTRICAL $ S-O,�� AMP SERVICE 0 PROGREBS ENERGY Q W.R,E,C. <br /> / <br /> QPl.UMBiNG �> � � ��� � � <br /> � � <br /> QMECHAtSlCA� $ VALUATlQN OF MECHANtCAL INSTALLATIOtV <br /> QGAS Q ROOFING � SPECIAL'fY � O7HER <br /> fiNtSFiEf3 f{.00R ElEVATION� �� F�t}OD ZONE AREA QY£S NO � �� � <br /> BUILDER � �-_--___�� COMPANY � <br /> SIONATURE � RE�IsrertEo Y/ N FEE CUftRE� Y/N <br /> � <br /> Address �---. �— �'� License# � ^ _ <br /> e��crr��c�ara �pn�v La Srqh f 4'�r e� <br /> SICiNAT(tRE � REGISTERED /N FEE CURREA Y 1 N <br /> Address ���! , 4�, Licsnse#� 2�-j'�� [��(�,"j�[� <br /> PLUMBER � � COMPANY � <br /> SIGNATURE � REGISfERED Y! N FEECURREP Y!N <br /> Address Llcanse# ���� <br /> MEGNANICAL � � COMPANY �� <br /> SIGNATURE REGIStERED Y I N �E CURREA Y/N <br /> ( Address 1.3cense# ���� <br /> �l'�,:.,�/�C i�CL� <br /> .�s- coiararJr C'J U�L� �_ ��,N `'��' <br /> $IGNATURE [�clsrEa� Y( N FEe curu�en <br /> Address License# I �� <br /> IIMIIIIIIIt111111111111111111111111111111l1 / lt1111111 / e / 11111 / ! 1l11 <br /> RESID8h1FlAL Attach{2}Plat Plans;{2}sets of 8upding Plans;{i}set of Energy FQnns;R-O-W Pecmit for r�ew constructlon, <br /> Minimum ten(10}working days after submiUal date. Required onsite,Cons6vction Plens,Stortnwater Plans w!Silt Fence installed, <br /> Sanftary Facililies 8 1 dumpster,Sike Work Permit for subdivisionsAarge projects <br /> COMMERCtAL Attach(3}comp{eta sets pf 8uilding Plans plus a Life Safety Page;(t)set of Energy Forms.f2-4-W Permii fpr new canstruc6an. <br /> Minlmum ten{i0)waticing days aftet suhmitkaf date. Reqaired�site,Canstructton Ptans,Storsnwater Plans wl Sift Fence installed, <br /> Senitary Fecilities&1 dumpster.Site Wor1c PermR for all new prajects.All commercial requirements must meet compiiance <br /> SIGN PERMIT Atta�h(2)sets of Eng(neered Plans. <br /> ""PROPERTY SURVEY tequired fpr aR NEW co�sGuc6on. <br /> Dlr�ctlans: <br /> Fill out application completely. <br /> Ovmer&Contractor sign 6ack of apptication,natarized <br /> if over 52500,e Notice of Commeneement Is raqulrad. (A/C upgrades over$T500) <br /> " Agent(for the contracWr)or Power of Attomey(for the ownerj tvould be someone wiCh notarized letter hom owner authorizing same <br /> BVER T?iE COUNTER PERM#T'f1NC, jFrpnt of Appficafion Qnty} <br /> Reroafs if shingles Sawers Service Upgrades AIC Fences(PIoUSurvey(Footage) <br /> Orlveways-Nat over Counter if on pubfic roadways..needs f20W <br />