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8��-�ao-ooza City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Bu3lding department <br /> Dafe Etecelved Phone-Contact for PermitEin <br /> Owner's Name C4��t" ri � �t`tJ'��� �YWb�a't?� Owner Phane Number � a� �"�J��.� <br /> '" ��- �a ?- �9 ,�� <br /> Owner's Addrass +��4 a l � � i � Owner Phone Number <br /> Fee Simple Titleholder Name �i � Owner Phane Number � _ � <br /> 0 <br /> Fee Slmple Titleholder Address <br /> JOB ApDRESS <br /> 3$ �0�'{ �� J� 2�h`"t rh.;tt5 �t, 3 3 5y.2. LOT# �_Z�____J <br /> suBaivisoN� <<-�to-a1-o0�0�4'�ToO• PARCE4.ID# <br /> tS�R�Q (O@TAINED PROM PROPERTY 7AX NQTICE) <br /> WORK PROpOSED �NEW CONSTR ApD/ALT � SIGN [� Q DEMOI.ISH <br /> e INSTALL 8 REPAIR <br /> PROPOSED.USE �, SFR Q Ct�MM [„� OTHER <br /> TYPE OF CON3TRUCTION , BLOCK � Q FRAME C� STEEL Q <br /> � <br /> DESCRIPTION OF WORK @ I A,C E C�`r l/J�'.1� (� ,Yl C': <br /> BUILDING SIZE ���� SQ F007AGE g�� HEIGHT � �'�' <br /> �BUILDiNG $ '�''"� �r�.�_.::. `-�.- <br /> '1,.` a� VALUATION OF TO7AL CONSTRUCTION <br /> QELECTRICAL ($� � AMP SERVICE Q PROGREBS ENEI2GY [� W.R.E.C. <br /> � <br /> QPt�UMBlNG $ rf� 1��}� <br /> �G is <br /> �MECHANiCAI $ VAIUATION OF NtECHANICAL INSTALtAT10N <br /> � �. <br /> QGAS [� ROQFING Q SPECIAI.TY Q OTNER <br /> FINISHED FLOOR ELEVATIQNS C�'--___� FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE-CURRE� .Y/N r <br /> Address Cicense# �� � <br /> �. <br /> ELEGTRtCIAN ., COMPANY <br /> SIGNATURE RECaISTERED Y/ N FEE CUFtRE� Y/N <br /> Addres� � � License# � � <br /> PLUMBER � � COMPANY �1l�o.ro t'"�P't�' O�'Y1G (7Cli � <br /> SIGNA7URE' REGISTEREp Y/ N FEE CURRE� Y/N ' <br /> Address Ltcense# � � �� <br /> MECHANlCAR. COMPAWY <br /> SIGNATURE REGISTERED Y�./ N FEE CURRE� Y/N <br /> Address ' License# �� � <br /> o��R SE'�,.� conn�artv �4�'t� Dt�t'1,E f. <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� . . Y-/N. <br /> Address ~ ` L'Icense# �� -� <br /> RESIDEN17A1; Attach(2}Plot Plans;{2}sets of+Bu3lcling'Plans;(1}set af�Erierc,�y�Porms;R-t)-W PerrrBit for new construc6on, <br /> . Minimum�ten,(1,0}:working,d"ays after.submittal date. Required ansite,ConstiucHan-Plans;Stormwate�°Plans vd Silt Fence installed, <br /> Sanilary FacillUes.&;1;,dumpster,�Site�Wotic�Rermit far sutiiiivistansflarge pro�ects _ ' , <br /> COMMERCiAL A#tach{3j complete sefs of Builclitig Plan`s plus a life Safety Page;{1)set of Energy Forms.R O-W Permit for new construcflon. <br /> Mlnimum ten(10)working days after submittal date. Requtred ansite,ConstrucGon Pians,Stormwater Plan's w/Sflt Ferice installed, <br /> Sanitary Facliitles&1 dumpsiec.Slte Work Permft for aif new proJei�.Aii cammerciafxequlrements must meet comptfance <br /> SIGN PERMIT Attach`(2)s`ets of Engiiieer,ed Ptans.�,_ � ,° •. <br /> `«""PROPERTY SURVEY'reguired for all NEW cansttucUan. , ' <br /> DtreaElons: <br /> FIII out applicaUon completely. <br /> Owner&Contractor slgn back of appifca�on,natarized <br /> If over�2500,a Notice af Commencement la required. (A!C upgrades over 5750Q) <br /> " Agent(for ttie contraotor)ar Power of Attomey(for the ouvner)woutd be§omeone with notarized letter from owner authorizing same_,, <br /> OVER THE C4UNTER PERMITTING (Front of Appiication Only)., . � � � , <br /> Reroofs if shingles Sewers Seroice Upgrades A/C Fenaes('PIoUSurvey/Footage)` <br /> Driveways-Not over Counter if on public.roadways::needs°ROW" ' � ,� <br />