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. <br /> ' 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Departrnent <br /> Date Received ''��j �, phone Contact for Permitting 813 994 _ 0101 <br /> owner's Name Chufch of Chflst owner Phone Number 352-4240144 <br /> owners Address `J4'�4 4th St Zephyrhills,FL 33542 ovmer Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> �.,...FE'ks..�:bt�-RPa�YecL�(Lva/L.�O.�atu..a�s+E4tr+%fi�✓�u1: <br /> Fee Simple TitleholderAddress � f.Gt+�P.;�li � A>,�� �' <br /> JOBQDDRESS 54444th St Zephyrh+ls, ,F,L �§4'�i I� roiz�irnn�oJ ��'1 y"' <1 LOT# � <br /> . �'n��t,r�tiiqr.3.�t„�c r f ' `„�n�.. <br /> SUBDIVISION ; ��' 11-26-21-0d1a-0�i00 110 <br /> '� � (O AI D ROPERTYTA%NOTICE) � <br /> WORK PROPOSED NEW cANSTR ADD/ALT Q SIGN � Q DEMOLISH <br /> , e INSTALL B REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE O�CONSTRUCTION Q BCOCK Q' FRAME Q STEEL Q <br /> DESCRIP710N OF WORK Illuminated Monument Sign <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � � ��� <br /> �/ �� <br /> QBUILDING $ • a� VALUATION OF TOTAL CANSTRUCTION /� <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.EC. <br /> OPLUMBING $ � ��� A�^_ �� <br /> �J lt/Y\ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLAl10N _ y�� � � <br /> �tf <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER /,4��g-��`�7 V,- ��if�` <br /> I�IT`�' <br /> FINISHEDFLOORELEVATIONS FLOODZONEAREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURREN Y I N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y I N <br /> Address .. .---:A, �_-�ivn,��-�.m�._.....<_'wu -:�, License# <br /> r I ` t ' ` ' . ';J',I , )i -'f Y <br /> !�. �x� <br /> PLUMBER � -, t�t;i.' .;;i;��"�•� :,�MPANY'� <br /> r,-:f.. <br /> SIGNATURE '� : ' - ;,,. `:iteGisTeRE4�� Y/ N FEE WRREN Y/N <br /> Address `' :_...,...v....d .,.�;-,.�..w--,>� vR "� License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> o7HER Roberto Hiller + coMPANY Signarama of New Tampa <br /> SIGNATURE REGISTERED ( N FEECURREN Y/N <br /> Address 1917 Passero Ave Lu�,FL 33559 License# ES12001402 <br /> IIIIIIIIIIIIIIIIIIItti1tt11Itt111111111it1111111111111111111111it11 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-aW Permft for newconstruction, <br /> Minimum ten(10)worldng days aftersubmittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsllarge pmjects <br /> COMMERCIAL Attach(2)complete sets of Building Pians plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days aftersubmittal date. Required onsite,Cons[ruction Plans,Stortnwater Pians w/Silt Fence installed, <br /> Sandary Facili[ies&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions:• <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,a Notice of CommencemeM is required. (AIC upgrades over$7500) I <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notar¢ed letter from owner author¢ing same <br /> OVER THE COUNTER PERMITTING (copy of conVact required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />